A comparative study of maternal and fetal outcomes in women with or without epidural analgesia during labour

Background: Epidural analgesia is considered the gold standard for labour pain relief . Despite its widespread acceptance, concerns continue regarding its influence on labour progression, mode of delivery, maternal complications, and neonatal outcomes. Our study aimed to compare maternal and fetal outcomes between women receiving epidural analgesia and those undergoing labour without epidural analgesia. Methods: A hospital-based observational comparative study was conducted at a tertiary care centre, from October 2025 to April 2026. Seventy primigravid women with single term pregnancies were enrolled, 35 women received epidural analgesia using low-dose Ropivacaine with Fentanyl, while 35 women underwent labour without epidural analgesia. Maternal haemodynamic parameters, labour characteristics, mode of delivery, maternal complications, pain relief, neonatal Apgar scores, need for neonatal resuscitation, and NICU admission were compared between the two groups. Results: Baseline demographic and obstetric characteristics were comparable between both groups. Epidural analgesia produced excellent pain relief with stable maternal haemodynamics. A transient reduction in systolic blood pressure was observed during the first 15–20 minutes after epidural administration without clinically significant adverse effects. The duration of the second stage of labour was slightly prolonged in the epidural group; however, there was no statistically significant increase in caesarean delivery or adverse neonatal outcomes. Apgar scores, neonatal resuscitation, and NICU admissions were comparable between the groups. Conclusions: Low-dose epidural analgesia is a safe and effective technique for labour pain management. It provides superior maternal comfort without adversely affecting maternal or neonatal outcomes and should be offered to eligible women delivering in tertiary care centres.