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The effect of intrapartum epidural analgesia on nulliparous labor: a randomized, controlled, prospective trial
1Department of Obstetrics and Gynecology, St. Luke's Hospital, Kansas City, MO.
Objective:
Our purpose was to determine the effect of epidural analgesia on nulliparous labor and delivery.
Study Design:
Normal term nulliparous women in early spontaneous labor were randomized to receive either narcotic or epidural analgesia.
Results:
When compared with the group receiving narcotic analgesia (n = 45), the group receiving epidural analgesia (n = 48) had a significant prolongation in the first and second stages of labor, an increased requirement for oxytocin augmentation, and a significant slowing in the rate of cervical dilatation. Epidural analgesia was associated with a significant increase in malposition (4.4% vs 18.8%, p < 0.05). Cesarean delivery occurred more frequently in the epidural group (2.2% vs 25%, p < 0.05), primarily related to an increase in cesarean section for dystocia (2.2% vs 16.7%, p < 0.05).
Conclusions:
In a randomized, controlled, prospective trial epidural analgesia resulted in a significant prolongation in the first and second stages of labor and a significant increase in the frequency of cesarean delivery, primarily related to dystocia.