Epidural labor analgesia and the incidence of cesarean delivery for dystocia

Anesthesia and Analgesia
S T FogelJ S Smeltzer

Abstract

We performed this retrospective study to examine the changes in cesarean delivery rates associated with the establishment of a labor epidural service. In April 1993, St. Louis Regional Medical Center established an on-demand labor epidural service. We obtained demographic data for all patients and reviewed the operative records of all patients undergoing cesarean section who delivered 12 mo before and 16 mo after the start of the labor epidural service. We compared labor epidural rates and total and nulliparous dystocia cesarean delivery rates before and after the epidural service started and among patients who did and did not receive labor epidural analgesia when it was available. Included were 3195 patients who delivered before and 3733 patients who delivered after epidural analgesia became available. Labor epidural rates were 1.2% vs 29.4% for the Before group versus the After group (P < 0.001). Total (9.1% vs 9.7%) and nulliparous dystocia (5.7% vs 6.4%) cesarean delivery rates did not significantly change with the availability of epidural analgesia. However, the total (11.6% vs 8.8%; P = 0.009) and dystocia (8.0% vs 1.0%; P = 0.001) cesarean delivery rates were higher among patients who received epidural analgesia when it ...Continue Reading

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Citations

Nov 13, 2001·Obstetrics and Gynecology·M K YanceyM Klebanoff
Jan 23, 2002·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Giorgio Capogna
Dec 22, 2010·British Journal of Anaesthesia·C R Cambic, C A Wong
Nov 26, 1999·Clinical Obstetrics and Gynecology·J A Thorp
Sep 16, 2003·Clinical Obstetrics and Gynecology·Shiv K Sharma, Kenneth J Leveno
Sep 17, 2010·American Journal of Therapeutics·Richard W Hong
Dec 23, 2004·Paediatric Drugs·Giorgio Capogna, Michela Camorcia
Feb 1, 2005·Best Practice & Research. Clinical Anaesthesiology·Robert R Gaiser
Apr 17, 2004·Journal of Clinical Nursing·Astrid NystedtAnia Willman
May 15, 2002·Seminars in Perinatology·Barbara L Leighton, Stephen H Halpern
Feb 21, 2006·Midwifery·Astrid NystedtBerit Lundman
May 16, 2002·American Journal of Obstetrics and Gynecology·Barbara L Leighton, Stephen H Halpern
Aug 3, 2001·American Journal of Obstetrics and Gynecology·J ZhangD Schweitzer
Apr 18, 2003·Anesthesiology Clinics of North America·Stephen H Halpern, Barbara L Leighton
Oct 3, 2006·Current Opinion in Anaesthesiology·J L Buxbaum
Oct 3, 2006·Current Opinion in Anaesthesiology·A P Robinson, G Lyons
Jan 24, 2003·The New England Journal of Medicine·Holger K EltzschigWilliam R Camann
Jul 3, 1999·The New England Journal of Medicine·R K DeMott, H F Sandmire
Mar 17, 2000·Anesthesiology·A MacarioE Riley
Nov 1, 2002·International Anesthesiology Clinics·Scott Segal

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