[When should peridural analgesia be started in induced labor? Result of a randomized prospective study]

Two groups of women who had labours induced were compared in a prospective randomised trial: The first group of 41 patients (group 1) in whom the epidural was started at the beginning of induction. A second group of 47 patients (group 2) in whom the epidural was only started when labour became "active" and induction had been effective. The length of labour and the obstetrical results were identically the same in both groups: at least there was no significant difference. There was no special benefit from waiting until labour started properly before injecting the epidural. This result made us look retrospectively to women whose labours had been induced and who might have benefited from the epidural being started late. The only significant difference was found apparently between primipara and multipara, and this was quite independent of the state of the cervix and the lower segment at the onset: it would appear to be better to put the epidural analgesia in once the labour has started in primiparous patients where as in multiparous ones on the other hand there seems to be a better effect if the epidural is started as soon as induction is started.