Incidence and Factors Involving Cesarean Delivery After Epidural Analgesia for Labor

Study Overview
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Brief Summary
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The rate of cesarean delivery after epidural analgesia for labor has not been reported in our institute. The aim of this study is to elucidate incidence of cesarean delivery in parturient whom received epidural analgesia. Besides, factors associated with the rate of cesarean delivery were studied.

Detailed Description
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Epidural analgesia with local anesthetic and opioid is the efficiently good method to relieve labor pain comparing with intravenous opioid analgesic. Many literatures reported effects epidural analgesia for labor eg. prolonging the duration of second stage of labor, increasing the rate of instrumental delivery: vacuum extraction and forceps assisting labor. Some papers revealed the increasing in the rate of cesarean delivery. The main reason is assume to be a failure to progress labor after epidural analgesia. However, the recent report from Cochrane database systematic review showed no relation of epidural analgesia for labor and the increasing in the rate of cesarean delivery. Various factors that may involve in the increasing in the rate of cesarean delivery including the dilatation of cervix at the time of insertion of epidural catheter, nulliparous, size of the fetus or motor weakness after receiving epidural medication. The rate of cesarean delivery after epidural analgesia for labor has not been reported in our institute. The aim of this study is to elucidate incidence of cesarean delivery in parturient whom received epidural analgesia. Besides, factors associated with the rate of cesarean delivery were studied.

Official Title
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Incidence and Factors Involving Cesarean Delivery After Epidural Analgesia for Labor

Conditions
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Cesarean Section, Epidural; Anesthesia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age>,= 18 years Accept epidural analgesia for labor ASA classification I-II Exclusion Criteria: Unable to communicate Thai

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of cesarean delivery after epidural analgesia for labor | Rate of cesarean delivery after patients receive epidural analgesia for relieve labor pain | From epidural catheter insertion to delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Factors affecting rate of cesarean delivery after epidural analgesia for labor | cervical dilatation before insertion epidural catheter (cm.) | at the time epidural catheter insertion | 
| Efficacy of epidural analgesia for labor | pain score (verbal rating scale pain score) | before and after epidural catheter insertion | 
| Side effects of epidural analgesia for labor: nausea and vomiting | nausea and vomiting (rating by patients: 0= no symptom, 1= nausea 2= vomiting) | From epidural catheter insertion to delivery | 
| Side effects of epidural analgesia for labor: pruritus | pruritus (0=no, 1=yes) | From epidural catheter insertion to delivery | 
| Side effects of epidural analgesia for labor: numbness of legs | numbness of legs (0=no, 1=yes) | From epidural catheter insertion to delivery | 
| Side effects of epidural analgesia for labor: motor weakness | Rate motor weakness by Bromage score | From epidural catheter insertion to delivery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Epidural analgesia, Labor pain, Cesarean section rate