Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 722-730, 2006

Effect of Availability of a Parturient-elective Regional Labor Pain Relief Service on the Mode of Delivery

  • Li-Kuei Chen

      Affiliations

    • Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Li-Kuei Chen, Department of Anesthesiology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan
    • ,
  • Tony Hsiu-Hsi Chen

      Affiliations

    • Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received 3 November 2005; received in revised form 30 November 2005; accepted 7 February 2006.

Article Outline

Background/Purpose

Regional analgesia for labor pain relief is effective and widely used. This study evaluated the controversial association between mode of operative delivery and patient-elective labor regional analgesia.

Methods

We retrospectively compared the rates of instrumental vaginal and cesarean deliveries in parturients before the introduction, in the first 15 months after, and in the subsequent 36 months after the implementation of an elective labor regional analgesia service. A total of 9779 low-risk singleton cephalic pregnancies above 36 weeks of gestation were included. The maternal and fetal outcomes for parturients before the service was implemented and in those with or without pain relief service in the two postimple-mentation periods were analyzed. Multivariate logistic regression analyses were used to investigate the effects of maternal age, gestational weeks and newborn weight, in addition to regional analgesia, on the mode of delivery in nulliparous women.

Results

After adjusting for maternal age, gestational weeks, and newborn weight, no significant association was found between regional analgesia and cesarean delivery in nulliparas. Further, this lack of association was not affected by the receipt of regional analgesia in the early period of program implementation or in the period after staff had become familiar with the service. A higher rate of instrumental vaginal delivery was noted in nulliparas given regional analgesia.

Conclusion

Regional analgesia for pain relief increased the likelihood of instrumental vaginal delivery, but did not increase the likelihood of cesarean delivery.

Key Words:  cesarean delivery , instrumental vaginal delivery , regional analgesia

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PII: S0929-6646(09)60200-X

doi:10.1016/S0929-6646(09)60200-X

Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 722-730, 2006

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