Epidural analgesia and instrumental delivery

Lumbar epidural analgesia in labour: relation to fetal malposition and instrumental delivery.

The incidence of instrumental delivery and malposition immediately before delivery was compared in patients who were given lumbar epidural analgesia and those who were not. Instrumental delivery was five times more common and a malposition of the fetal head was more than three times as common in the epidural group as in women who did not receive regional analgesia. Similar incidences were found...

Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review.

OBJECTIVE Review of the literature regarding the relation between the timing of epidural analgesia and the rate of caesarean or instrumental vaginal deliveries. SEARCH STRATEGY Pubmed, Embase and the Cochrane Library were searched for articles published until 31 July 2010. SELECTION CRITERIA Studies were selected in which the effects of early latent phase (defined as a cervical dilatation o...

Epidural analgesia for labor and delivery.

n engl j med 362;16 nejm.org april 22, 201

Continuous lumbar epidural analgesia for labour and delivery.

No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour.

Context Wassen and colleagues have published an article on a topic of great practical importance: Does epidural analgesia (EA) given early in labour (≤3 cm cervical dilatation) increase the risk of instrumental delivery, compared with EA administered later in labour? This is important because EA is the most effective labour analgesia, and, if the timing of its administration is not associated w...