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The Effect of Epidural Analgesia on the Maternal and Fetal Outcomes in Mothers Undergoing Induction of Labour

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Abstract

Introduction

Elective labour induction is associated with more pain, intrapartum interventions, cesarean deliveries, as compared with spontaneous labour, necessitating the use of labour analgesia. Epidural analgesia is one popular method for control of pain. This study was to determine the effect of epidural analgesia on the maternal and fetal outcomes in women undergoing induction of labour, as adequate data in this specific population is relatively sparse.

Materials and Methods

This was a cross-sectional study conducted over a period of 18 months which included mothers with singleton term gestation with cephalic presentation admitted for induction of labour.

Result

A sample of 238 mothers were included in the study. Among the study population, 52.7% opted for epidural analgesia. The pain score was less than 3/10 (VAS) in 81% of mothers who opted for epidural analgesia. The cesarean section rate was 20.5% and 34.3% in the epidural and non-epidural groups, respectively. After adjusting the confounding factors, there was a positive effect noted in the caesarean section rate among the epidural group, which was lesser than the non-epidural group. However, a higher instrumental delivery rate (18.8% vs. 10.5%, p-value < 0.05) was noted in the epidural group. There was no significant difference in the duration of labour and fetal outcome in the two groups.

Conclusion

Epidural analgesia providing good pain relief in the majority of the mothers was reinforced. In our study, epidural analgesia was associated with a reduction of caesarean section rate after adjusting the confounding factor. Epidural analgesia did not affect the duration of labour, cesarean section rate and fetal outcome independently, however, it was associated with increased risk of instrumental delivery. The outcomes mainly depend on the confounding factors. Therefore, mothers can be provided with an evidence-based information regarding the effect of epidural analgesia in induced labour and help those seeking epidural analgesia to make an informed choice.

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References

  1. Corton MM, Leveno KJ, Bloom SL, et al. Williams obstetrics. 24th ed. New York: McGraw Hill Education; 2014. p. 1376p.

    Google Scholar 

  2. Glantz JC. Elective induction versus spontaneous labor associations and outcomes. J Reprod Med. 2005;50(4):235–40.

  3. Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011;12, Article ID CD000331.

  4. Jones L, Othman M, Dowswell T, et al. Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev. 2012; no. 3, Article ID CD009234.

  5. Martin JA, Hamilton BE, Sutton PD, et al. Births: final data for 2005. Natl Vital Stat Rep. 2007;56:1–104.

    PubMed  Google Scholar 

  6. Harkins J, Carvalho B, Evers A, et al. Survey of the factors associated with a woman’s choice to have an epidural for labor analgesia. Anesthesiol Res Pract. 2010;2010, Article ID 356789, 8 pages.

  7. Lancaster SM, Schick UM, Osman MM, et al. Risk factors associated with epidural use. J Clin Med Res. 2012;4:119–26.

    PubMed  PubMed Central  Google Scholar 

  8. Torricelli M, Voltolini C, Conti N, et al. Weight gain regardless of pre-pregnancy BMI and influence of fetal gender in response to labor induction in postdate pregnancy. J Maternal-Fetal Neonatal Med. 2013;26(10):1016–9.

    Article  Google Scholar 

  9. Baranova A, Gowder SJ, Schlauch K, et al. Gene expression of leptin, resistin, and adiponectin in the white adipose tissue of obese patients with non-alcoholic fatty liver disease and insulin resistance. Obes Surg. 2006;16(9):1118–25.

    Article  Google Scholar 

  10. Halvadia SH, Halvadia HB, Joshi RM, et al. A study of fetomaternal outcome of epidural analgesia during labour. Natl J Med Res. 2013;3(2):184–6.

    Google Scholar 

  11. Hitzeman N, Chin S. Epidural analgesia for labor pain. Am Fam Physician. 2012;86(3):241–3.

    PubMed  Google Scholar 

  12. Hasegawa J, Farina A, Turchi G, et al. Effects of epidural analgesia on labor length, instrumental delivery, and neonatal short-termoutcome. J Anesth. 2013;27(1):43–7.

    Article  Google Scholar 

  13. Leighton BL, Halpern SH. The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. Am J Obstet Gynecol. 2002;186(supplement 5):S69–77.

    CAS  PubMed  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. Ashagrie HE, Fentie DY, Kassahun HG. A review article on epidural analgesia for labor pain management: a systematic review. Int J Surg Open. 2020;24:100–4.

    Article  Google Scholar 

  16. Mędrzycka-Dabrowska W, Czyż-Szypenbej K, Pietrzak J. A review of randomized trials comparisons of epidural with parenteral forms of pain relief during labour and its impact on operative and cesarean delivery rate. Ginekologia Polska. 2018;89(8):460–7. https://doi.org/10.5603/GP.a2018.0079.

    Article  PubMed  Google Scholar 

  17. Naito Y, Ida M, Yamamoto R, et al. The effect of labor epidural analgesia on labor, delivery, and neonatal outcomes: a propensity score-matched analysis in a single Japanese institute. JA Clin Rep. 2019;5:40.

    Article  Google Scholar 

  18. Cambic CR, Wong CA. Labour analgesia and obstetric outcomes. Br J Anaesth. 2010;105:i50–60.

    Article  Google Scholar 

  19. Singh SK, Yahya N, Misiran K, et al. Combined spinal-epidural analgesia in labour: its effects on delivery outcome. Braz J Anesthesiol. 2016;66(3):259–64.

    Article  Google Scholar 

  20. Chen S-Y, Lin P-L, Yang Y-H, et al. The effects of different epidural analgesia formulas on labor and mode of delivery in nulliparous women. Taiwan J Obstet Gynecol. 2014;53(1):8–11.

    Article  Google Scholar 

  21. Jadon A, Agrawal A, Chakraborty S, et al. Early versus late epidural analgesia; effect on obstetric outcomes. J Anaesth Crit Care. 2016;2:10467.

    Google Scholar 

  22. Sodha S, Reeve A, Fernando R. Central neuraxial analgesia for labor: an update of the literature. Pain Manage. 2017;7(5):419–26.

    Article  Google Scholar 

  23. Kearns RJ, Shaw M, Gromski PS, et al. Association of epidural analgesia in women in labor with neonatal and childhood outcomes in a population cohort. JAMA Netwk Open. 2021;4(10):e2131683.

    Article  Google Scholar 

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Acknowledgments

We thank our institute, Bangalore Baptist Hospital, for giving us the opportunity to do this study. We would like to immensely thank our family and colleagues for their support and constant encouragement. We also thank all the patients who participated in the study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Bangalore Baptist Hospital, Bangalore, Karnataka, India

    G. R. Abhirami (Junior resident) & C. Sathyavani (Senior consultant)

  2. Community Health and Palliative Care Division, Bangalore Baptist Hospital, Bangalore, Karnataka, India

    Carolin Elizabeth George (Senior consultant)

Authors
  1. G. R. Abhirami
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  2. C. Sathyavani
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  3. Carolin Elizabeth George
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by G.R.Abhirami, C.Sathyavani and Carolin Elizabeth George. The first draft of the manuscript was written by G.R.Abhirami and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to G. R. Abhirami.

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The authors declare that they have no conflict of interest.

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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Informed consent was obtained from all individual participants included in the study.

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Abhirami, G.R., Sathyavani, C. & George, C.E. The Effect of Epidural Analgesia on the Maternal and Fetal Outcomes in Mothers Undergoing Induction of Labour. J Obstet Gynecol India 72 (Suppl 1), 174–179 (2022). https://doi.org/10.1007/s13224-022-01622-1

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  • DOI: https://doi.org/10.1007/s13224-022-01622-1

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