Adverse effects of epidural analgesia in labor

Objective: To examine the influence of epidural analgesia on labor and deli very in nulliparous and multiparous women. Design: Data were collected on 8 47 consecutive parturients with singleton pregnancy and vertex presentation (384 nulliparous and 463 multiparous). The obstetrical and labor character istics including maternal age, parity, gestational age, previous cesarean s ection, instrumental delivery, mode and timing of analgesia, mode of delive ry, indications for cesarean section or instrumental delivery were analyzed comparing patients who received epidural analgesia with women who received systemic analgesia. Results: Epidural analgesia was administered in 233 nu lliparous and 141 multiparous women. A stepwise logistic regression analysi s revealed that epidural analgesia independently affected the rate of non-s pontaneous delivery and the duration of the second stage of labor in nullip arous (P = 0.0017 and P = 0.0036, respectively) and multiparous (P = 0.001 and P = 0.0081, respectively) women. Epidural analgesia independently affec ted the duration of labor only in nulliparous women (P = 0.0001). Conclusio n: Women should be informed that prolongation of labor and increase in nons pontaneous deliveries should be expected when choosing epidural analgesia i n labor. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.