Labor epidural analgesia in pre-eclampsia: a prospective study

J Obstet Gynaecol Res. 2005 Aug;31(4):291-5. doi: 10.1111/j.1447-0756.2005.00290.x.

Abstract

Aim: To assess the safety of labor epidural analgesia in subjects with pre-eclampsia.

Methods: Nulliparous laboring women were included in the prospective study. One hundred pre-eclamptic nullipara who were given epidural analgesia (group I) were compared with 100 nullipara with pre-eclampsia who were not given epidural analgesia (group II). The outcome was further compared with 200 women who were not pre-eclamptic, but who were given epidural analgesia (group III), and also with 200 women who were normotensive and who were not given epidural analgesia (group IV).

Results: In group I, 58% of subjects delivered normally compared with 60% in group II. The operative vaginal delivery rate was 28% in group I compared with 24% in group II (P = 0.62), and the cesarean section rate was 14% and 16% in groups I and II, respectively, (P = 0.8). The difference was not statistically significant. The incidence of a prolonged second stage of labor was also not increased in pre-eclamptic women who received epidural analgesia. Five of the neonates in group I had a 5-min APGAR score <6 compared with seven neonates in group II. The necessity of neonatal resuscitation was also not significantly increased in group I (P = 1.0). The incidences of fetal distress (P = 0.71), non-progressive second stage of labor (P = 0.66) and cephalopelvic disproportion (P = 0.90) were not statistically different in the pre-eclampsia group compared with the non-pre-eclampsia group. Similar results were noted when these outcome measures were compared with the other two groups. With regard to hypotension and tachycardia in the pre-eclamptic subjects who were given epidural analgesia, no statistical difference (P = 0.72) was seen when compared with the normotensive subjects.

Conclusion: In the absence of coagulopathy, epidural analgesia is a safe and effective method for labor pain relief, even for subjects with pre-eclampsia.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesia, Epidural*
  • Analgesics / administration & dosage
  • Bupivacaine / administration & dosage
  • Delivery, Obstetric / methods*
  • Female
  • Humans
  • Labor, Obstetric / physiology*
  • Pre-Eclampsia*
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Tramadol / administration & dosage
  • Treatment Outcome

Substances

  • Analgesics
  • Tramadol
  • Bupivacaine