Izvorni znanstveni članak
Vaginal Delivery and Continuous Epidural Analgesia: Should We Change Our Clinical Approach?
Nebojša Sindik
Oleg Petrović
Marinka Manestar
Vedran Frančišković
Marko Klarić
Marinko Marić
Sažetak
The aim of the study was to investigate the effects of continuous epidural analgesia (EA) on the course of vaginal delivery
with an emphasis on duration of labor and instrumental interventions. In a prospective 2-year trial, the study
group included singleton vaginal births between 35 and 41 gestational weeks with a vertex fetus, in which continuous EA
with bupivacaine or chirocaine in concentration of 0.125% combined with 2–4 mg of fentanyl or 0.5 mg of sufenta was
used. The control group was created randomly from laboring patients with singleton pregnancies but without EA. The
groups were adjusted for epidemiological characteristics and compared regarding the obstetric data and perinatal outcome.
Student t-test and Mann-Whitney U-test were performed for normally and non-normally distributed results, respectively.
Out of 1284 patients, 551 pregnant women were included in the study group and 733 in the control group. The
statistically significant differences between the groups related to duration of the first and second stage of labor, frequency
of premature rupture of membranes, intrapartal complications, and incidence of operative deliveries were found. Both
stages of labor were significantly protracted and the incidence of operative deliveries was higher in the study group of patients
compared with controls. There is a need for an active obstetric approach and management of vaginal deliveries of
women who receive continuous EA, particularly if it is medically indicated.
Ključne riječi
epidural analgesia; instrumental delivery; intrapartum complications; labor; operative delivery; outcome
Hrčak ID:
84808
URI
Datum izdavanja:
10.7.2012.
Posjeta: 805 *