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The Effect of Early Epidural versus Early Intravenous Analgesia Use on Labor Progression: A Natural Experiment

Citation

Vahratian, Anjel; Zhang, Jun; Hasling, Jill; Troendle, James F.; Klebanoff, Mark A.; & Thorp, John M., Jr. (2004). The Effect of Early Epidural versus Early Intravenous Analgesia Use on Labor Progression: A Natural Experiment. American Journal of Obstetrics & Gynecology, 191(1), 259-265.

Abstract

OBJECTIVE: The purpose of this study was to compare the effect of early epidural with the use of early intravenous analgesia on labor progression.
STUDY DESIGN: We systematically selected singleton, nulliparous term pregnancies with a spontaneous labor and analgesia placement RESULTS: After adjustment had been made for confounders, women in the after period had a slower labor progression only from 4 to 5 cm, compared with those women in the before period. Interestingly, the process of labor admission and epidural analgesia placement, rather than analgesia use per se, appeared to explain most of the slowdown. No significant difference in the rest of the active phase was observed between the 2 groups.
CONCLUSION: Our data support recent American College of Obstetricians and Gynecologists guidelines that the restraining use of epidural analgesia at <4 cm of cervical dilation is unnecessary.

URL

http://dx.doi.org/10.1016/j.ajog.2003.11.021

Reference Type

Journal Article

Year Published

2004

Journal Title

American Journal of Obstetrics & Gynecology

Author(s)

Vahratian, Anjel
Zhang, Jun
Hasling, Jill
Troendle, James F.
Klebanoff, Mark A.
Thorp, John M., Jr.