[Peridural anesthesia and method of delivery. Peridural anesthesia performed by the obstetrician]

In deliveries in epidural analgesia (PDA) there are more obstetrical operations than in deliveries without PDA. We have investigated the delivery mode in relation to the indication of epidural analgesia. If the PDA is done because of prolonged course of labour or because of suspicious fetal heart rate, about 40% of these women deliver spontaneously, in about 35% a cesarean is done, and in about 25% a forceps- or vacuum-extraction is done. This high rate of operative interventions is not unexpected due to the indication that led to epidural analgesia. If the PDA is done because of painful labour only, 60% of these mothers deliver spontaneously, 12% by cesarean and about 28% by forceps or vacuum. The rate of vaginal extractions is triple as in all obstetric patients of the clinic. The increase of operative deliveries in PDA isn't found generally. Epidural analgesia managed by the obstetrician doesn't result in more complications by the method itself, the increase of operative deliveries is found even in clinics where the PDA is carried out by the anesthetist. The possible reasons are discussed.