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title:A Study of Fetomaternal Outcome of Epidural Analgesia During Labour

Author:Shital H Halvadia, Hardik B Halvadia, Rachit M Joshi, Devanshi P Upadhyaya

Keywords:Epidural analgesia, Labour, Apgar score, Mode of delivery.

Type:Original Article

Abstract:Background: Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. This produces pain relief with minimal side effects. These medications may be used in combination with epinephrine, fentanyl, morphine, or clonidine to prolong the epidural’s effect or to stabilize the mother’s blood pressure. Objectives: This study was conducted to assess the fetomaternal outcome of epidural analgesia in labour. Methods: This study was descriptive case series study which was conducted in department of obstetrics and gynecology, GMERS medical college, Gandhinagar, Gujarat from January 2012 to December 2012. Pregnant women who received epidural analgesia during labour were involved in the study. The inclusion criteria were primi gravida patients who had gestational age of greater than 37 weeks (confirmed by ultrasound) without any risk factors, in true labour (cervical dilatation >3 cm with regular uterine contraction) and with vertex presentation. Results: Total number of patients was 80 with the mean age of 21.9±1.7 years. Mode of delivery was spontaneous vaginal in 46 patients (57.5%), forceps delivery in 4 patients (5%), ventouse in 14 patients (17.5%) and caesarean section in 16 patients (20%). At one minute majority of the babies (n 63, 78.75%) had Apgar score of more than 7, only 5 babies (6.25%) had Apgar score less than 4, and 12 babies (15%) had Apgar score between 4-7. At 5 minutes majority of the babies (n 74, 92.5%) had Apgar score of more than 7, only one baby (1.25%) had Apgar score less than 4, and 5 babies (6.25%) had Apgar score between 4-7. Conclusion: Epidural anaesthesia provided excellent pain relief in majority of the patients. It can also be associated with increase duration of second stage of labour but not associated with fetal compromise in a properly managed patient.

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