Impact of epidural on labor duration and vacuum deliveries in twin gestations.
Midwifery
; 74: 134-139, 2019 Jul.
Article
em En
| MEDLINE
| ID: mdl-30953969
ABSTRACT
INTRODUCTION:
Epidural analgesia may lead to a prolonged second stage, and increased instrumental vaginal deliveries rate in singleton gestations. We aimed to examine the association between epidural and vacuum deliveries rate and second stage duration among twin deliveries.METHODS:
Retrospective study conducted at a single teaching hospital on data between January 1995 and December 2015. All twin pregnancies, >24 weeks that had a trial of labor were included. Twins with major malformations, intrauterine death, or had a caesarean delivery without a trial of labor, were excluded. Women were divided to those who had an epidural analgesia (group 1) and those who did not (group 2). Primary outcome was vacuum delivery rate.RESULTS:
Of all 1955 twin pregnancies delivered during the study period, 827 (42.3%) were eligible and included; 332 (40.1%) in group 1 and 495 (59.9%) in group 2. Vacuum delivery rate of any twin was 7.5% and 6.3% in groups 1 and 2, respectively (pâ¯=â¯0.48; Relative Risk 1.20; 95% Confidence Interval 0.72-2.0). Vacuum delivery rate of first twin only or second twin only did not differ significantly as well. After adjusting for variables that differed significantly between the groups in univariate analysis, second stage duration of first and second twins in group 1 was significantly longer than in group 2 (pâ¯=â¯0.001; ratio=1.66; 95% Confidence Interval 1.42-1.94 and pâ¯=â¯0.001; ratio=1.40; 95% Confidence Interval 1.24-1.58, respectively).CONCLUSIONS:
Epidural use in twin deliveries did not affect vacuum deliveries rate. Epidural was associated with a prolonged second stage of both twins.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fatores de Tempo
/
Vácuo-Extração
/
Trabalho de Parto
/
Analgesia Epidural
/
Gravidez de Gêmeos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Midwifery
Assunto da revista:
ENFERMAGEM
/
OBSTETRICIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Israel