Abstract
OBJECTIVE: Our purpose was to measure effects of epidural analgesia on labor compared with boluses of meperidine in a cohort of women with similar clinical circumstances. STUDY DESIGN: One hundred ninety-nine nulliparous women who were delivered spontaneously at term and who received oxytocin for labor augmentation before the initiation of analgesia were identified for analysis. All these women were managed in a low-risk labor unit according to a standardized protocol. This management protocol encouraged early amniotomy and the use of oxytocin when ineffective labor was diagnosed. RESULTS: The demographic characteristics of the two study groups were similar with respect to age, height, weight, and maternal age. The two groups had the same cervical dilatation on admission (3.3 cm) and at the time of analgesia administration (4.1 vs 4.2 cm), indicating similar progress of labor before oxytocin administration. The length of the active phase of labor was longer in the epidural group (7.9 vs 6.3 hours, p = 0.005), as was the second stage (60 vs 48 minutes, p = 0.03). The mean and maximal rates of oxytocin infusion were similar between the two study groups; however, the amount of oxytocin required for each centimeter of cervical change was more in the epidural group (22 vs 16 mU per cm of cervical change, p = 0.009). Neonatal outcomes were unaffected by the type of labor analgesia. CONCLUSION: Epidural analgesia decreases uterine performance during oxytocin-stimulated labor, resulting in an increase in the length of the first and second stages of labor.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 516-520 |
| Number of pages | 5 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 178 |
| Issue number | 3 |
| DOIs | |
| State | Published - 1998 |
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Keywords
- Anesthesia
- Epidural
- Labor
ASJC Scopus subject areas
- Medicine(all)
- Obstetrics and Gynecology
Cite this
The course of labor with and without epidural analgesia. / Alexander, J. M.; Lucas, M. J.; Ramin, S. M.; McIntire, D. D.; Leveno, K. J.
In: American Journal of Obstetrics and Gynecology, Vol. 178, No. 3, 1998, p. 516-520.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The course of labor with and without epidural analgesia
AU - Alexander, J. M.
AU - Lucas, M. J.
AU - Ramin, S. M.
AU - McIntire, D. D.
AU - Leveno, K. J.
PY - 1998
Y1 - 1998
N2 - OBJECTIVE: Our purpose was to measure effects of epidural analgesia on labor compared with boluses of meperidine in a cohort of women with similar clinical circumstances. STUDY DESIGN: One hundred ninety-nine nulliparous women who were delivered spontaneously at term and who received oxytocin for labor augmentation before the initiation of analgesia were identified for analysis. All these women were managed in a low-risk labor unit according to a standardized protocol. This management protocol encouraged early amniotomy and the use of oxytocin when ineffective labor was diagnosed. RESULTS: The demographic characteristics of the two study groups were similar with respect to age, height, weight, and maternal age. The two groups had the same cervical dilatation on admission (3.3 cm) and at the time of analgesia administration (4.1 vs 4.2 cm), indicating similar progress of labor before oxytocin administration. The length of the active phase of labor was longer in the epidural group (7.9 vs 6.3 hours, p = 0.005), as was the second stage (60 vs 48 minutes, p = 0.03). The mean and maximal rates of oxytocin infusion were similar between the two study groups; however, the amount of oxytocin required for each centimeter of cervical change was more in the epidural group (22 vs 16 mU per cm of cervical change, p = 0.009). Neonatal outcomes were unaffected by the type of labor analgesia. CONCLUSION: Epidural analgesia decreases uterine performance during oxytocin-stimulated labor, resulting in an increase in the length of the first and second stages of labor.
AB - OBJECTIVE: Our purpose was to measure effects of epidural analgesia on labor compared with boluses of meperidine in a cohort of women with similar clinical circumstances. STUDY DESIGN: One hundred ninety-nine nulliparous women who were delivered spontaneously at term and who received oxytocin for labor augmentation before the initiation of analgesia were identified for analysis. All these women were managed in a low-risk labor unit according to a standardized protocol. This management protocol encouraged early amniotomy and the use of oxytocin when ineffective labor was diagnosed. RESULTS: The demographic characteristics of the two study groups were similar with respect to age, height, weight, and maternal age. The two groups had the same cervical dilatation on admission (3.3 cm) and at the time of analgesia administration (4.1 vs 4.2 cm), indicating similar progress of labor before oxytocin administration. The length of the active phase of labor was longer in the epidural group (7.9 vs 6.3 hours, p = 0.005), as was the second stage (60 vs 48 minutes, p = 0.03). The mean and maximal rates of oxytocin infusion were similar between the two study groups; however, the amount of oxytocin required for each centimeter of cervical change was more in the epidural group (22 vs 16 mU per cm of cervical change, p = 0.009). Neonatal outcomes were unaffected by the type of labor analgesia. CONCLUSION: Epidural analgesia decreases uterine performance during oxytocin-stimulated labor, resulting in an increase in the length of the first and second stages of labor.
KW - Anesthesia
KW - Epidural
KW - Labor
UR - http://www.scopus.com/inward/record.url?scp=0031957220&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031957220&partnerID=8YFLogxK
U2 - 10.1016/S0002-9378(98)70431-4
DO - 10.1016/S0002-9378(98)70431-4
M3 - Article
C2 - 9539519
AN - SCOPUS:0031957220
VL - 178
SP - 516
EP - 520
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 3
ER -