The effect of epidural analgesia on obstetric lacerations and neonatal outcome during spontaneous vaginal delivery

Abstract 

The aim of this study was to determine if epidural analgesia is associated with increased risk of obstetric lacerations during spontaneous vaginal delivery. We also assessed the effect of epidural analgesia on maternal and neonatal parameters. This multicenter study consisted of an analysis of data from the delivery databases of the University Hospital of Vienna and the Semmelweis Women’s Hospital Vienna. This study was restricted to a sample that included all women with uncomplicated pregnancy, a gestational age >37 weeks and a pregnancy with cephalic presentation. Epidural analgesia was started during the first stage of labour. Techniques and management styles of epidural analgesia were the same in both hospitals. We found that women undergoing epidural analgesia had a prolonged second stage of labour, a higher rate of episiotomy and an increased use of oxytocin. Some of these adverse effects might be caused by the higher rate of primipara in the epidural group. However, epidural analgesia showed no evidence of a detrimental effect on the integrity of the birth-canal and on neonatal outcome during spontaneous vaginal delivery.