EFFECTS OF EPIDURAL ANALGESIA ON THE MOTHER AND FETUS IN LABOUR

Abstract

Background: The present study is to evaluate the effect of epidural analgesia on maternal and fetal outcome. That is the duration and progress of labor, mode of delivery (spontaneous vaginal/instrumental/operative),  requirement of oxytocin augmentation, Apgar score of newborn, complications following epidural analgesia and effectiveness of analgesia on labor. Methods: This prospective study was conducted at J.L.N.M.C.H Bhagalpur, a total number of 60 patients who were primigravida with full term singleton pregnancy with vertex presentation in established early labor who come under the inclusion criteria were divided randomly into two groups, group-A received epidural analgesia and group-B did not receive epidural analgesia. A detail history, P/A, P/V examination, investigations were done and epidural catheter inserted once the patient enters active phase of labor. RESULTS: Age group of patients varied from 20 – 25 years (70%) in group A and (66.7%) in group B. There was significantly increased use of oxytocin in Group A. Epidural analgesia has shortened the duration of ? stage of labor by 13.10 min and prolonged II stage of labor, when compare to control group. Maximum patients [25 (96.5%)] did not have motor blockade. Epidural analgesia has not increased the rate of instrumental vaginal delivery (6.7% vs. 0) and cesarean section rate (16.7% vs. 10%) when compare to control group. In group A-There were 11 (36%) neonates who had Apgar score ? 7 at 1 min and no neonates with Apgar score ? 7 at 5 min. In group B -There were 6 (20%) neonates who had Apgar score ? 7 at 1 min and no neonates with Apgar score ? 7 at 5 min. There were 23 (92%) patients in group A who had no pain. CONCLUSION: We concluded that epidural analgesia did not affect duration of labor or cesarean section rate and has no effect on perinatal outcome and can therefore be recommended to mothers as a satisfying and effective method of pain relief of labor.

Keywords:  Apgar score; Epidural Analgesia; Instrumental delivery.