Does epidural analgesia cause dystocia?

Journal of Clinical Anesthesia
T T ThompsonW A Bowes

Abstract

To analyze the effects of epidural analgesia for labor when dystocia occurs. Retrospective cohort study. Academic health center. 641 low risk, nulliparous women in spontaneous labor. 406 (63%) women received epidurals analgesia and 253 (37%) did not. Sixty women (9.4%) required an abdominal delivery for dystocia. Women receiving epidural analgesia were more likely to be white, receive care from an attending physician, need labor augmentation, and deliver a heavier infant. Multivariate analysis identified five variables predictive of dystocia and abdominal delivery: pitocin augmentation odds ratio (O.R.) = 3.9 (2.0 to 7.6), duration of labor more than 20 hours O.R. = 2.4 (1.3 to 4.4), high epidural dose O.R. = 2.2 (1.2 to 4.1), birthweight over 4,000 grams O.R. = 2.0 (1.0 to 4.2), and early placement of epidural O.R. = 1. 9 (1.0 to 3.5). Repeating the regression after excluding the 20 women who developed abnormal labor prior to epidural placement (18 of 20 women had protracted dilatation) demonstrated that pitocin augmentation O.R. = 4.0 (1.8 to 4.), high epidural dose O.R. = 3.0 (1.9 to 6.2), duration of labor greater than 20 hours O.R. = 2.7 (1.3 to 5.7), and birthweight over 4,000 grams O.R. = 2.1 (0. 9 to 4.8) were associate...Continue Reading

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Citations

Nov 26, 1999·Clinical Obstetrics and Gynecology·J A Thorp
Apr 17, 2004·Journal of Clinical Nursing·Astrid NystedtAnia Willman
May 16, 2002·American Journal of Obstetrics and Gynecology·Ellice Lieberman, Carol O'donoghue
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Jan 7, 2000·Anesthesia and Analgesia·E SheinerM Katz
Mar 30, 2000·Primary Care·M B StephensS A Fields

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