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Women's
Health Childbirth
Epidurals - effective, but not without risks
Though the benefits are a less painful labour, new research conducted at
the Women's Centre, John Radcliffe Hospital, Oxford, UK suggests that
epidurals can cause significant longer delays during the second stage of
labour, sometimes even resulting in an increased vaginal delivery rates.
Researchers in England investigating the
effects of epidural analgesia on blood
pressure, duration of the second stage and mode of delivery found that
epidural analgesia
provides a very effective form of pain relief in labour and has a lowering
effect on the blood pressure, which can be useful in those suffering from
high blood pressure disease in pregnancy. However, it now seems that there
are potential risks associated with the procedure.
The researchers monitored 122 women
about to give birth; of which 81 had epidural blocks and 41 had other
forms of analgesia during labour. Over seventy per cent of those who chose
epidural were first time pregnancies compared with only thirty four per
cent in the non-epidural group.
During labour, minimum diastolic blood
pressure was found to be significantly lower in the epidural group: 65.8
versus 72.4 mmHg and the average duration of the second stage of labour
was significantly longer in the epidural group: 108.3 versus 41.6 minutes,
28/81. 34.6 per cent of the epidural group needed operative vaginal
deliveries compared with just 14.6 per cent in the non-epidural group.
These results suggest that, though more
women in their first pregnancy tend to prefer an epidural, they are
unaware of the increased risk of a labour assisted vaginal delivery and a
longer second stage of labour.
Source : Int J Clin Pract 1999
Sep;53(6):418-20. Update
on some aspects of the use of epidural analgesia in labour. Okojie
P, Cook P
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This page was last updated on 19 October 2006 11:17:00
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