Document Detail


Factors influencing the selection of analgesia in spontaneously labouring nulliparous women at term.
MedLine Citation:
PMID:  9325507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated the maternal characteristics, labour performance and delivery mode of 497 nulliparas entering labour spontaneously at term to identify the obstetric factors which influenced their choice of analgesia; 51.7% of these women used epidural analgesia. They were shorter (163 versus 165 cm, p = 0.002) and the mean gestation was 3 days greater than those not using epidural analgesia (40.2 versus 39.6 weeks, p = 0.0007). Median birth-weight in the epidural group was greater by 155 g (3,450 versus 3,295 gs, p = 0.0001). Analysis of the labour characteristics showed a lesser cervical dilatation on admission, significantly longer latent and active phases of labour and second stage length in the epidural cohort. The need for oxytocin augmentation was significantly greater in the epidural group, both prior to and after insertion. Oxytocin augmentation was strongly associated with an increased risk of operative intervention regardless of analgesia. Selection of intrapartum analgesia is not a random event and epidural analgesia appears to be an indicator of abnormal labour patterns. To further investigate the impact of analgesic methods on nulliparous labour we are currently conducting a prospective randomized controlled trial.
Authors:
J E Dickinson; M Godfrey; S F Evans; J P Newnham
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  37     ISSN:  0004-8666     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-11-26     Completed Date:  1997-11-26     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  289-93     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, King Edward Memorial Hospital for Women, Subiaco, Western Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Epidural / statistics & numerical data*
Analgesia, Obstetrical / statistics & numerical data*
Analgesics, Opioid / administration & dosage
Birth Weight
Cesarean Section / statistics & numerical data
Choice Behavior*
Cohort Studies
Female
Gestational Age
Humans
Infant, Newborn
Labor Stage, Second / drug effects
Meperidine / administration & dosage
Obstetric Labor Complications / epidemiology*
Oxytocin / administration & dosage
Pregnancy
Retrospective Studies
Risk
Western Australia
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 50-56-6/Oxytocin; 57-42-1/Meperidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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