The effect of epidural analgesia on labour and neonatal outcome: a comparitive study / Norziah Aman

Background: Pain relief in labour is an important issue in the management of pregnant women in childbirth. Epidural analgesia is currently the most effective method for pharmacological intra-partum pain relief and most widely applied during childbirth. Various adverse effects of Epidural Analgesia have been described and remains controversial among the healthcare professionals involved. Aims of the study: To evaluate the effects of epidural analgesia on Labor Progress and Neonatal Outcome at Hospital Putrajaya. Materials and method: Retrospective Cohort Study using secondary data collected through Electronic Medical Record (THIS; Total Hospital Information System) on all delivery cases in Hospital Putrajaya from 1 st January to 31 9 st December 2016 and entered into Case Report Form (CRF) that was developed through previous study and validated by the Obstetrician and Anaesthesiology in Hospital Putrajaya Result: A total of 906 respondents was retrospectively investigated in a cohort of 8000 delivery in a government hospital; and was divided into two groups of 453 respondents with epidural analgesia and non-epidural analgesia. These result showed that epidural mothers had better outcome of delivery; mode of delivery (t: -8.05; p-value: 0.01), perineal tear (x²: 69.46; p-value: 0.01), duration of labour (t: -12.58; p-value: 0.01), the incidence of Post-Partum Haemorrhage (x : 22.45; p-value: 0.01) and the estimated blood loss for mother with epidural analgesia had less blood (U: 85057.50; p-value: 0.01) compared to the other group. The neonates whose mothers received epidural analgesia were significantly had better outcome; Apgar score values at 5 minutes (x²: 13.89; p-value: 0.01), developed Transient Tachypnea of the New-born (x²: 8.16; p-value: 0.01) and admitted to Neonatal Intensive Care Unit (x²: 5.61; p-value: 0.02) compared to the neonate whose mothers with other analgesia method / no analgesia (non-epidural group). Conclusion and recommendation: Overall, it can be concluded that the effects of epidural analgesia are good to the maternal and neonatal. However, these should be a proper guideline or care for mothers with epidural analgesia to encourage a better outcome and satisfaction amongst mothers who use epidural analgesia as pain relief during labour.