A randomized trial of labor analgesia in women with pregnancy-induced hypertension

Michael J. Lucas, Shiv K. Sharma, Donald D. McIntire, Jackie Wiley, J. Elaine Sidawi, Susan M. Ramin, Kenneth J. Leveno, F. Gary Cunningham

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this study was to compare the peripartum and perinatal effects of epidural with intravenous labor analgesia in women with pregnancy-induced hypertension. STUDY DESIGN: Women with pregnancy-induced hypertension who had consented to participate were randomized to receive either epidural or intravenous analgesia for labor pain. Both methods were given according to standardized protocols. All women received magnesium sulfate seizure prophylaxis. Obstetric and neonatal outcomes were compared according to intent-to-treat allocation. RESULTS: Seven hundred thirty-eight women were randomized: 372 women were given epidural analgesia, and 366 women were given intravenous analgesia. Maternal characteristics were similar, including the severity of hypertension. Epidural analgesia was associated with a significantly prolonged second-stage labor, an increase in forceps deliveries, and an increase in chorioamnionitis. Cesarean delivery rates and neonatal outcomes were similar. Pain relief was superior with the epidural method. Hypotension required treatment in 11% of women in the epidural group. CONCLUSION: Epidural labor analgesia provides superior pain relief but no additional therapeutic benefit to women with pregnancy-induced hypertension.

Original languageEnglish (US)
Pages (from-to)970-975
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume185
Issue number4
DOIs
StatePublished - 2001

Fingerprint

Trial of Labor
Pregnancy Induced Hypertension
Analgesia
Epidural Analgesia
Second Labor Stage
Labor Pain
Chorioamnionitis
Peripartum Period
Pain
Magnesium Sulfate
Surgical Instruments
Hypotension
Obstetrics
Seizures
Mothers
Hypertension

Keywords

  • Epidural analgesia
  • Hypertension
  • Pregnancy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

A randomized trial of labor analgesia in women with pregnancy-induced hypertension. / Lucas, Michael J.; Sharma, Shiv K.; McIntire, Donald D.; Wiley, Jackie; Sidawi, J. Elaine; Ramin, Susan M.; Leveno, Kenneth J.; Cunningham, F. Gary.

In: American Journal of Obstetrics and Gynecology, Vol. 185, No. 4, 2001, p. 970-975.

Research output: Contribution to journalArticle

Lucas, Michael J. ; Sharma, Shiv K. ; McIntire, Donald D. ; Wiley, Jackie ; Sidawi, J. Elaine ; Ramin, Susan M. ; Leveno, Kenneth J. ; Cunningham, F. Gary. / A randomized trial of labor analgesia in women with pregnancy-induced hypertension. In: American Journal of Obstetrics and Gynecology. 2001 ; Vol. 185, No. 4. pp. 970-975.
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