Epidural analgesia in association with duration of labor and mode of delivery: A quantitative review☆,☆☆
Section snippets
Material and methods
We conducted a MEDLINE search on the key words epidural, labor, forceps, cesarean, and delivery. Articles published in English from 1965 to December 1997 were potentially eligible for this review. We narrowed the search to those focusing on the effects of epidural analgesia on duration of labor and mode of delivery. We collected these articles and searched for other potentially eligible studies by cross-checking all the references in these reports. We found 32 published original studies that
Randomized clinical trials by Chestnut et al
Chestnut et al6, 7, 10 conducted 3 of the 7 randomized clinical trials, 2 of them with a double-blind design. These studies were intended to examine whether continuing epidural analgesia in the second stage of labor affects the course of labor and mode of delivery in the second stage.6, 7 Both studies enrolled nulliparous patients with a term singleton gestation and vertex presentation. All patients had epidural analgesia in the first stage, but about half of them had normal saline solution
Comment
Whether epidural analgesia increases the risk of cesarean delivery and prolongs labor has been intensely debated during the last decade.17 Unfortunately, good studies are few and most have had small numbers of subjects. Randomized clinical trials are difficult to perform because epidural analgesia has been commonly used and provides superb pain relief during labor. Method switching, mostly from the control group to the epidural group, diminishes the ability to interpret randomized clinical
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2021, American Journal of Obstetrics and GynecologyRisk factors for severe perineal trauma during childbirth: An updated meta-analysis
2020, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Outcomes retrieved in the present meta-analysis were based in the findings of the previous meta-analysis published in this field [7]. Data extraction was performed using a modified data form that was based in Cochrane`s data collection form for intervention reviews for RCTs and non-RCTs [10]. The methodological quality of included studies was independently assessed by two authors (M.F. and N.V.) using the Newcastle-Ottawa Scale (NOS), which evaluates the selection of the study groups, the comparability of the groups and the ascertainment of the exposure or outcome of interest [11].
Labor epidural analgesia and the incidence of instrumental assisted delivery
2015, Medicina (Lithuania)Citation Excerpt :Since EA was introduced for labor pain relief, the controversy about the relation between EA and instrumental deliveries, cesarean section, as well as prolonged labor has originated. Further studies, however, found no EA association with increased cesarean section rate, but discussions regarding its influence on instrumental assisted delivery (IAD) rate and duration of labor persist [7–21]. The study was performed in the maternal unit of a tertiary perinatology center.
A randomized clinical trial of the efficacy of applying a simple protocol of boiled Anethum Graveolens seeds on pain intensity and duration of labor stages
2014, Complementary Therapies in MedicineRisk factors for severe perineal lacerations during childbirth
2014, International Journal of Gynecology and Obstetrics
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Reprint requests: Jun Zhang, MB, PhD, Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, Building 6100, Room 7B03, Bethesda, MD 20892-7510.
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