A Prospective Cohort Study Analysing Maternal & Foetal Outcome of Epidural Analgesia in Primiparous- A Boon or Bane!

Introduction: Childbirth is a multidimensional experience and when considering treatment, one must balance between pain relief and other aspects, such as physical, emotional, psychological, sociologic, and sometimes religious considerations.In other words, pain relief may not be enough to make childbirth a fulfilling and satisfactory experience.In this section we will consider the goals of therapy for labor pain and how neuraxial analgesia helps to accomplish these goals.The aim of the study was to evaluate the effect of epidural analgesia on duration of labor, maternal and foetal outcome.Methodology: The present study was a prospective cohort study conducted in a tertiary care hospital in Dept. of obstetrics & gynaecology.Registration of patients was from August 2016 to July 2017.The women in labor who have fulfilled inclusion criteria are enrolled in the study.They were counselled when they were admitted in labor room, during 1st stage of labor.Detailed history was taken according to the proforma.General physical examination done.Systemic examination including per cephalopelvic disproportion.The primary outcome was duration of labor (first and second stage of labor).Secondary outcome measures were the incidence of vaginal delivery, caesarean sections and instrumental vaginal delivery.Neonatal outcome in form of APGAR score at 5 min noted.Result: Both the groups were matched with respect to characters like maternal age, height, weight, gestational age.Total number of patients in this study were 40.Majority of patients were between 20-26 years with mean age of 23.45 years & 24.45 yrs in epidural & control Gp. respectively.Results of present study demonstrated that epidural analgesia provides excellent pain relief.There was statistically significant difference in mean duration of first stage of labor in both groups with p value of <0.05 which is statistically significant.In regard of mode of delivery there was no Statistically significant difference observed in both groups.Perception of pain in EA group was very low with 100% of patients giving good VAS score.Patients acceptability in EA group was 100 % all of them were interested to take epidural analgesia in next labor. Conclusion:Epidural analgesia is commonly performed to relieve labor pain.Compared with other techniques, it is the most effective form of analgesia.Recent innovations in drug combinations and delivery systems have resulted in a flexible technique that meets the needs of most parturients in a safe and effective manner.