Intrapartum Epidural Anesthesia and Obstetric Outcome in Nulliparous Women with Term Labor: An analysis of 2 years’ Experience

Aim: to ascertain whether labour profiles and delivery outcomes of nulliparous women who received epidural analgesia were comparable to those of women whose labour was managed with alternative forms of pain relief. Patients and Methods: a prospective, randomised, controlled clinical study carried out in Saudi German and Elhussine University hospitals. Recruitment was open to 100 nulliparous women planning a vaginal delivery of a term singleton foetus. Results: 100 women, with gestational age of 37–41 completed weeks, were chosen at random to receive either continuous epidural analgesia (EPI) or alternative forms of pain relief (NEPI). Compared to the EPI group, the NEPI group's labour took less time to deliver (P<0.05). The first stage's mean duration was 3.7 ± 1.1 hours compared to 4.8 ± 3.1 hours (P < 0.05), while the second stage's mean duration was 102.4 ± 9.3 minutes compared to 132.1 ± 15.8 minutes (p < 0.05). The mean NEPI dose of oxytocin was 10.5 ± 2.3 units, while the mean EPI dose was 15.6 ± 2.5 units (p < 0.05). While NEPI groups had higher rates of spontaneous vaginal deliveries and caesarean sections than EPI groups, NEPI groups required fewer surgical deliveries overall (p < 0.05). VAS scores during labour were less significantly in EPI group (p < 0.05). Conclusion: Regardless of their intention to labour, nulliparous women use epidural analgesia frequently. Other pain management techniques are linked to a slight but statistically significant decrease in the average length of labour and the rate of surgical delivery in women who do not plan to use epidural analgesia as their primary analgesic modality.