Comparison of Rate of Instrumental Delivery with and without Epidural Analgesia

Abstract

Introduction: Epidural analgesia is commonly employed for managing labor pain, but its influence on assisted deliveries and subsequent outcomes for mothers and infants remains debatable. Objectives: Primary: To compare the rate of instrumental delivery with and without epidural analgesia in pregnant women in the labor room for vaginal delivery in a tertiary care hospital. Secondary: To determine the effect of epidural analgesia on duration of labor, obstetric anal sphincter injury, neonatal outcomes (birth weight, APGAR scores, birth injury, NICU admission, shoulder dystocia), Materials and Methods: The present study after gaining approval from the institutional review board, enrolled all booked and unbooked, primigravidas and multigravidas, with a singleton pregnancy, aged 15-45 years, in the labor room for a vaginal delivery (with or without epidural analgesia) on a non-probability consecutive basis. All patients provided informed voluntary informed consent after they were informed about the pros and cons of participating in the study. The data was noted in a predesigned proforma. Results: A total of 120 patients were enrolled in the study as per the inclusion criteria, of which 67 (55.8%) were given epidural analgesia. Induction of labor was done in 95% of the participants. Prolonged labor was reported in 27 mothers. Instrumental delivery was done in 30% of the mothers. Third degree OASI was reported in 5% of the mothers.  One neonate had birth injury with sublegal haematoma, two had shoulder dystocia, and three were admitted to NICU. The epidural analgesia had significant odds to result in instrumental delivery, and prolonged second stage of labor. Conclusion: The following study seeks to examine the complex relationship between epidural analgesia, assisted vaginal birth and its outcome on mothers and neonates. That epidural analgesia might contribute to higher levels of assisted deliveries stated that, yet there is a need to investigate the impact of epidural analgesia on certain maternal and neonate outcomes.