The impact of epidural analgesia on delivery mode in Robson class 1 women: a retrospective cohort studyAJOG MFM at a Glance

Fedora Ambrosetti, MD; Giovanni Grandi, MD; Elisabetta Petrella, MD; Veronica Sampogna, MD; Lara Donno, MD; Laura Rinaldi, MD; Anna Maria Ghirardini, MD; Fabio Facchinetti, MD

AJOG Global Reports (May 2023)

The impact of epidural analgesia on delivery mode in Robson class 1 women: a retrospective cohort studyAJOG MFM at a Glance

Fedora Ambrosetti, MD,
Giovanni Grandi, MD,
Elisabetta Petrella, MD,
Veronica Sampogna, MD,
Lara Donno, MD,
Laura Rinaldi, MD,
Anna Maria Ghirardini, MD,
Fabio Facchinetti, MD

Affiliations

Fedora Ambrosetti, MD: Department of Medical and Surgical Sciences for Mother, Child, and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (Dr Ambrosetti, XX Grandi, XX Petrella, XX Sampogna, and XX Facchinetti); Corresponding author: Fedora Ambrosetti, MD.
Giovanni Grandi, MD: Department of Medical and Surgical Sciences for Mother, Child, and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (Dr Ambrosetti, XX Grandi, XX Petrella, XX Sampogna, and XX Facchinetti)
Elisabetta Petrella, MD: Department of Medical and Surgical Sciences for Mother, Child, and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (Dr Ambrosetti, XX Grandi, XX Petrella, XX Sampogna, and XX Facchinetti)
Veronica Sampogna, MD: Department of Medical and Surgical Sciences for Mother, Child, and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (Dr Ambrosetti, XX Grandi, XX Petrella, XX Sampogna, and XX Facchinetti)
Lara Donno, MD: Anesthesia and Intensive Care Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (XX Donno, XX Rinaldi, and XX Ghirardini)
Laura Rinaldi, MD: Anesthesia and Intensive Care Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (XX Donno, XX Rinaldi, and XX Ghirardini)
Anna Maria Ghirardini, MD: Anesthesia and Intensive Care Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (XX Donno, XX Rinaldi, and XX Ghirardini); Anesthesia Unit, Ospedale di Sassuolo, Sassuolo, Italy (XX Ghirardini)
Fabio Facchinetti, MD: Department of Medical and Surgical Sciences for Mother, Child, and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy (Dr Ambrosetti, XX Grandi, XX Petrella, XX Sampogna, and XX Facchinetti)

Journal volume & issue: Vol. 3, no. 2
p. 100207

Abstract

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BACKGROUND: The use of epidural analgesia represents the gold standard for pain management during labor, but the influence of the use of epidural analgesia on delivery mode is not fully understood. OBJECTIVE: This study aimed to analyze the impact of epidural analgesia on the delivery mode, namely, cesarean delivery, vaginal delivery, and operative vaginal delivery rates, in Robson class 1 women. STUDY DESIGN: A retrospective cohort study was conducted on all Robson class 1 women who delivered from January 1, 2019, to December 31, 2019, in the University Hospital of Modena. The primary outcome was the delivery mode (cesarean delivery, vaginal delivery, and operative vaginal delivery rates), and the secondary outcomes were maternal, anesthesiologic, and neonatal effects of epidural analgesia (duration of labor, duration of the second stage of labor, Apgar score, and neonatal intensive care unit admission). RESULTS: A total of 744 women were included in the final analysis, of which 198 (26.6%) underwent epidural analgesia on request and 546 (73.4%) did not. In women with and without epidural analgesia, the cesarean delivery rate was 8.1% vs 7%, the vaginal delivery rate was 79.3% vs 81.1%, and the operative vaginal delivery rate was 12.6% vs 11.9%, respectively. A significant increase in both the first stage of labor (66.3±38.5 vs 43.8±38.8 minutes; P4 cm). No significant difference in Apgar score and neonatal intensive care unit admission was found. CONCLUSION: The use of epidural analgesia was not associated with an increased risk of cesarean delivery or operative vaginal delivery in Robson class 1 women. Further investigations are needed to evaluate its impact on the duration of labor, namely the duration of the first stage of labor, and on the possible advantages of starting epidural analgesia at an early stage.

Published in AJOG Global Reports

ISSN: 2666-5778 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Gynecology and obstetrics
Website: https://www.journals.elsevier.com/ajog-global-reports

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