Key result
A longer interval time from epidural analgesia to delivery (RR 1.11) and higher gestational age (RR 1.31) were significantly associated with an increased risk of cesarean section.
Why the study?
The study was conducted to explore the risk factors for cesarean section during a trial of labor with epidural analgesia.
Case-Control (n=100)
No
Higher BMI, advanced gestational age, and longer interval time from epidural analgesia are significant predictors of cesarean section during trial of labor.
Answers are grounded in this paper and cite their sources.
Should not yet change epidural or labor management; leaves open causal inference pending prospective validation.
Purpose of investigation: To explore the risk factors for cesarean section during trial of labor with epidural analgesia. Materials and methods: A total of 100 parturients who received epidural analgesia were selected for this study. Fifty parturients underwent vaginal deliveries and 50 parturients underwent cesarean sections. Patient-controlled epidural analgesia (PCEA) was carried out with the continuous infusion of 0.125% bupivacaine and 2 mcg/ml fentanyl at 6 ml/h with patient-controlled analgesia (6 ml/time, locked time 15 minutes). Results: The univariate analysis showed a significant difference in the gestational age of parturients between cesarean section and vaginal delivery (p = 0.013). Compared with the parturients in the vaginal delivery group, cesarean section group parturients showed longer interval time from epidural analgesia to cesarean section (p < 0.001), a higher number of analgesia interventions (p < 0.001), higher doses of PCEA (p < 0.001), and higher number of top-ups (p = 0.015). Multivariate analysis revealed that a high gestational age and long interval time were strongly associated with a high possibility of cesarean section during epidural analgesia. Conclusion: High gestational age and long interval time are important risk factors for the prediction of cesarean section during epidural analgesia.
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Wang et al. (2019) conducted a case-control in Labor (n=100). Long interval time from epidural analgesia to delivery vs. Shorter interval time was evaluated on Cesarean section (RR 1.11, 95% CI 1.08-1.14, p=<0.001). A longer interval time from epidural analgesia to delivery (RR 1.11) and higher gestational age (RR 1.31) were significantly associated with an increased risk of cesarean section.
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