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Breech delivery and epidural analgesia.

Y C Chadha¹, T A Mahmood, M J Dick

¹Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, UK.

British Journal of Obstetrics and Gynaecology

|February 1, 1992

Summary

Epidural analgesia prolonged labor and increased oxytocin use in women with breech presentations. It also significantly raised the rate of cesarean sections during the second stage of labor.

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Area of Science:

Obstetrics and Gynecology
Anesthesiology
Maternal-Fetal Medicine

Background:

Spontaneous labor in term singleton breech presentations presents unique challenges.
The role of epidural analgesia in managing such labors requires careful evaluation.

Purpose of the Study:

To assess the impact of epidural analgesia on labor progression and outcomes.
Specifically examining duration, augmentation needs, and cesarean section rates in term singleton breech presentations.

Main Methods:

Retrospective study design.
Analysis of data from 643 women with spontaneous onset of labor for term singleton breech presentations.
Outcome measures included labor duration, oxytocin augmentation, and cesarean section rates.

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Main Results:

Epidural analgesia was linked to significantly longer labor durations and increased oxytocin augmentation (P < 0.001).
No significant difference in first-stage cesarean rates was observed between groups.
A significantly higher likelihood of second-stage cesarean sections was found with epidural use in both primiparae and multiparae.

Conclusions:

Epidural analgesia is associated with prolonged labor and increased need for oxytocin augmentation.
Epidural use significantly increases the rate of cesarean sections in the second stage of labor for breech presentations.