Incidence and Factors Involving Cesarean Delivery After Epidural Analgesia for Labor
Study Details
Study Description
Brief Summary
The rate of cesarean delivery after epidural analgesia for labor has not been reported in our institute. The aim of this study is to elucidate incidence of cesarean delivery in parturient whom received epidural analgesia. Besides, factors associated with the rate of cesarean delivery were studied.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
|
Detailed Description
Epidural analgesia with local anesthetic and opioid is the efficiently good method to relieve labor pain comparing with intravenous opioid analgesic. Many literatures reported effects epidural analgesia for labor eg. prolonging the duration of second stage of labor, increasing the rate of instrumental delivery: vacuum extraction and forceps assisting labor. Some papers revealed the increasing in the rate of cesarean delivery. The main reason is assume to be a failure to progress labor after epidural analgesia. However, the recent report from Cochrane database systematic review showed no relation of epidural analgesia for labor and the increasing in the rate of cesarean delivery. Various factors that may involve in the increasing in the rate of cesarean delivery including the dilatation of cervix at the time of insertion of epidural catheter, nulliparous, size of the fetus or motor weakness after receiving epidural medication.
The rate of cesarean delivery after epidural analgesia for labor has not been reported in our institute. The aim of this study is to elucidate incidence of cesarean delivery in parturient whom received epidural analgesia. Besides, factors associated with the rate of cesarean delivery were studied.
Study Design
Outcome Measures
Primary Outcome Measures
- Incidence of cesarean delivery after epidural analgesia for labor [From epidural catheter insertion to delivery]
Rate of cesarean delivery after patients receive epidural analgesia for relieve labor pain
Secondary Outcome Measures
- Factors affecting rate of cesarean delivery after epidural analgesia for labor [at the time epidural catheter insertion]
cervical dilatation before insertion epidural catheter (cm.)
- Efficacy of epidural analgesia for labor [before and after epidural catheter insertion]
pain score (verbal rating scale pain score)
- Side effects of epidural analgesia for labor: nausea and vomiting [From epidural catheter insertion to delivery]
nausea and vomiting (rating by patients: 0= no symptom, 1= nausea 2= vomiting)
- Side effects of epidural analgesia for labor: pruritus [From epidural catheter insertion to delivery]
pruritus (0=no, 1=yes)
- Side effects of epidural analgesia for labor: numbness of legs [From epidural catheter insertion to delivery]
numbness of legs (0=no, 1=yes)
- Side effects of epidural analgesia for labor: motor weakness [From epidural catheter insertion to delivery]
Rate motor weakness by Bromage score
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age>,= 18 years
-
Accept epidural analgesia for labor
-
ASA classification I-II
Exclusion Criteria:
- Unable to communicate Thai
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Siriraj Hospital, Mahidol University | Bangkok | Thailand | 10700 |
Sponsors and Collaborators
- Mahidol University
Investigators
- Principal Investigator: Patchareya Nivatpumin, M.D., Mahidol University
Study Documents (Full-Text)
None provided.More Information
Publications
- Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018 May 21;5:CD000331. doi: 10.1002/14651858.CD000331.pub4. Review.
- Antonakou A, Papoutsis D. The Effect of Epidural Analgesia on the Delivery Outcome of Induced Labour: A Retrospective Case Series. Obstet Gynecol Int. 2016;2016:5740534. Epub 2016 Nov 20.
- Bannister-Tyrrell M, Ford JB, Morris JM, Roberts CL. Epidural analgesia in labour and risk of caesarean delivery. Paediatr Perinat Epidemiol. 2014 Sep;28(5):400-11. doi: 10.1111/ppe.12139. Epub 2014 Jul 18.
- Dickinson JE, Paech MJ, McDonald SJ, Evans SF. The impact of intrapartum analgesia on labour and delivery outcomes in nulliparous women. Aust N Z J Obstet Gynaecol. 2002 Feb;42(1):59-66.
- Klein MC. Does epidural analgesia increase rate of cesarean section? Can Fam Physician. 2006 Apr;52:419-21, 426-8. Review. English, French.
- Lucovnik M, Blajic I, Verdenik I, Mirkovic T, Stopar Pintaric T. Impact of epidural analgesia on cesarean and operative vaginal delivery rates classified by the Ten Groups Classification System. Int J Obstet Anesth. 2018 May;34:37-41. doi: 10.1016/j.ijoa.2018.01.003. Epub 2018 Mar 2.
- 020/2562 (EC4)