Retrospective analysis on the influence of epidural labor analgesia in delivery manner

Abstract

Objective To evaluate the influence of epidural labor analgesia in delivery manner. Methods The rates of epidural analgesia, spontaneous vaginal delivery, forceps delivery and cesarean section were calculated yearly and monthly from January of 2005 to December of 2006. The data of parturients who accepted epidural analgesia but deliveried with caesarean section were collected after a initina bolus, patient-controlled epidural analgesia(PCEA) started using 0.15% ropivacaine or 0.1% ropivacaine with 2 mg/L fentanil, with a bolus of 1～5ml, lockout interval of 15min and background infusion of 5 ml/h～8 ml/h when the cervix dilated at least 2 cm. Epidural infusion stopped at the moment of complete cervical dilatation. Results Compared to that in 2005, the rate of epidural labor analgesia(21.9% vs 33.8%, P＜0.05) and the rate of spontaneous vaginal delivery increased(51.7% vs 55.2%, P＜0.05) in 2006, the rate of forceps delivery unchanged(4.4%vs 4.7%, P＞0.05) and the rate of caesarean section decreased(43.9% vs 40.1%, P＜0.05) in 2006. The monthly rate of epidural analgesia was negatively correlated to the monthly rate of cesarean section (r=-0.678, P＜0.05). Conclusion Epidural labor analgesia provides opportunities of natural delivery for parturients who request cesarean section because of fearing labor pain, it decreases the rate of caesarean section, and increases the rate of spontaneous vaginal delivery to a certain extent. Whether epidural analgesia is responsible for the case of cesarean section needs further study. Key words: Epidural analgesia; Labor manner