Obstetrical outcome following epidural analgesia in 506 consecutive deliveries

We relate the experience of 506 consecutive deliveries under epidural analgesia in the same hospital, by the same obstetrician (JSS). 336 patients delivered without epidural analgesia during the same period. In the epidural group (n = 506), 93 patients had a normal spontaneous vaginal delivery, 357 had a low forceps, 22 had a mid-forceps, 4 had an assisted breech extraction, and 30 delivered by cesarean section. There were 24 cases (out of 506) of significant hypotension; all of them responded to an intravenous bolus of ephedrine. There was one case of accidental dural puncture that was treated with a blood patch. The degree of pain relief obtained by the epidural was deemed satisfactory in 456 patients (90%). The primary cesarean section rate in patients who received an epidural was not higher than that in patients who did not. Eleven newborns in the epidural group had one-minute Apgar scores between 4 and 6, but they all had excellent Apgar scores at five minutes. None had a one-minute Apgar score below 4. We conclude that epidural analgesia is a safe and highly effective method of pain relief during labor.