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Prospective study of effect of epidural analgesia during labour and maternal and neonatal outcome in tertiary care centre

Author: 
Dr. Sanjay P. Gadre and Dr. Asif Sayeed
Subject Area: 
Health Sciences
Abstract: 

Background and objectives: The pain of childbirth is the most severe pain, most women will endure in their lifetimes. Women in pain don’t need an “indication” for pain relief in labour. According to the American Society of Anesthesiology (ASA) “in the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labour” A prospective study was conducted with the approval of the hospital Ethics Committee. 60 parturient in labor were enrolled in the study after signing written informed consent. This study is descriptive case series study which was conducted in department of obstetrics and gynecology, from January 2017 to July 2017. Methodology: The inclusion criteria were • Nulliparity • Age 18-35 years • Gestational age >37 weeks • Single foetus with vertex presentation. Exclusion criteria included • Multigravida • Abnormal presentations :Breech,Transverse • Infection at the site of epidural • Coagulopathies • Any spinal deformities • History of allergy to local anesthetics, fentanyl or tramadol. All parturients were counseled on admission to the labor ward and those who were desirous of epidural analgesia were allocated to the epidural group (study group). Visual Analogue Pain Scale (VAPS) was used for quantification of pain at the peak of uterine contractions (0mm = no pain and 100mm = worst pain). Results: Parturient recruitment and data collection occurred over a period of two consecutive years. Out of the 60 parturients who participated, 50 completed the study. 10 patients from the epidural group were excluded as epidural analgesia was ineffective in 3 cases, data was incomplete in 4cases and in 3 cases caesarean was done before full cervical dilatation. Conclusion: Epidural analgesia, prolongs the first stage of labor, but is not associated with adverse maternal or neonatal outcome.

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