A Clinical Study of Effect of Epidural Anesthesia on Cesarean Delivery / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: This study was to evaluate whether epidural analgesia of labor is associated with an increased risk of cesarean delivery. METHOD: The study was undertaken for the clinical evaluation on the patients with singleton infants in vertex presentations who had been admitted and delivered at Soonchunhyang Kumi Hospital from January, 1996 to December, 1996. RESULT: The results were as follows : 1. There was no significant difference in incidence of cesarean delivery between nulliparous women receiving epidural analgesia(20.26%) and those who did not receive epidural analgesia(19.36%). But nulliparous women who received epidural analgesia were significant increase in operative vaginal delivery than those who did not receive epidural analgesia (0.08% of the no-epidural and 6.61% of the epidural group). 2. Among the indication for cesarean section, nulliparous women who received epidural analgesia were significant increase in incidence of failure to progress only than those who did not receive epidural analgesia (63.71% of the non-epidural and 84.78% of the epidural group). 3. There was no statistic significance in incidence of fetal distress only between women receiving epidural analgesia and those who did not receive epidural analgesia. 4. There showed no significant difference in new born Apgar score between women receiving epidural analgesia and those who did not receive epidural analgesia. 5. The subjective and objective successful epidural effects were noted excellent 22.91%, good 66.96% in nulliparous women and excellent 30.41%, good 61.48% in multiparous women. 6. Concerning complications of epidural anesthesia, backache was most frequent(8.00%), voiding difficulty, shivering, nausea/vomiting, hypotension, headache, dura puncture in orders. CONCLUSION: Our retrospective study shows that epidural analgesia may increase substantially the risk of operative vaginal delivery and the incidence of cesarean delivery for which failure to progress only was listed as an indication in nulliparous women. Although the causal nature of this association remains open to debate, prenatal care providers should routinely discuss the risks and benefits of epidural analgesia with women during their pregnancies so that can make informed decisions about the use of pain relief during labor.