Risk Assessments of Epidural Analgesia During Labor and Delivery

Clin Nurs Res. 2018 Sep;27(7):841-852. doi: 10.1177/1054773817722689. Epub 2017 Jul 28.

Abstract

Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies. However, women with EA were not and increased risk for perineal laceration or the condition of the membranes at the delivery or with the type of placental expulsion. Thus, the administration of EA should be assessed in each case by the health care professional.

Keywords: epidural analgesia; instrumental delivery; labor onset; labor progression; midwifery.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia, Epidural / adverse effects*
  • Analgesia, Epidural / statistics & numerical data
  • Female
  • Humans
  • Labor, Obstetric / drug effects*
  • Obstetric Labor Complications / etiology*
  • Obstetrical Forceps
  • Pain Management / methods
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Risk Assessment*