Second Stage of Labor and Epidural Use: a Larger Effect Than Previously Suggested

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 2014 Feb 7

PMID 24499753

Citations 24

Authors

Yvonne W Cheng

Brian L Shaffer

James M Nicholson

Aaron B Caughey

Affiliations

Soon will be listed here.

Abstract

Objective: To examine the length of second stage of labor with and without an epidural during labor.

Methods: This was a retrospective cohort study of 42,268 women who delivered vaginally with normal neonatal outcomes. Median lengths and 95th percentiles of second stage of labor were compared by epidural use with stratification by parity. Statistical comparisons were performed using the Kruskal-Wallis test and Kaplan-Meier survival analysis.

Results: Compared with women without epidural use, the 95th percentile length of second stage for nulliparous women was 197 minutes without epidural and 336 minutes with epidural (P<.001), a difference of 2 hours and 19 minutes. For multiparous women, the 95th percentile length of second stage was 81 minutes without epidural and 255 minutes with epidural (P<.001), a difference of 2 hours and 54 minutes.

Conclusion: Although recommendations for intervention during the second stage of labor have been made based on a 1-hour difference in the setting of epidural use, it appears that the 95th percentile duration is actually more than 2 hours longer with epidural during labor for both nulliparous and multiparous women.

Citing Articles

Maternal and perinatal outcomes of prolonged second stage of labour: a historical cohort study of over 51,000 women.

Young C, Bhattacharya S, Woolner A, Ingram A, Smith N, Raja E BMC Pregnancy Childbirth. 2023; 23(1):467.

PMID: 37349683 PMC: 10288707. DOI: 10.1186/s12884-023-05733-z.

Evaluation of woman-centred care status by Iranian midwives and providing strategies to improve women-centred care: A sequential explanatory mixed method study protocol.

Mashayekh-Amiri S, Nourizadeh R, Mohammad-Alizadeh-Charandabi S, Vaezi M, Meedya S, Mirghafourvand M Nurs Open. 2023; 10(9):6501-6508.

PMID: 37318288 PMC: 10415990. DOI: 10.1002/nop2.1901.

Emotional factors, medical interventions and mode of birth among low-risk primiparous women in Poland.

Nenko I, Kopec-Godlewska K, Towner M, Klein L, Micek A Evol Med Public Health. 2023; 11(1):139-148.

PMID: 37252430 PMC: 10224696. DOI: 10.1093/emph/eoad013.

The impact of epidural analgesia on delivery mode in Robson class 1 women: a retrospective cohort study.

Ambrosetti F, Grandi G, Petrella E, Sampogna V, Donno L, Rinaldi L AJOG Glob Rep. 2023; 3(2):100207.

PMID: 37168548 PMC: 10165263. DOI: 10.1016/j.xagr.2023.100207.

The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: A Propensity Score-Matched Analysis.

Zanfini B, Catarci S, Vassalli F, Longo V, Biancone M, Carducci B J Clin Med. 2022; 11(20).

PMID: 36294447 PMC: 9604843. DOI: 10.3390/jcm11206124.