Labor Pain Intensity At Epidural Doesn't Affect Delivery Mode


WASHINGTON — The intensity of women's labor pain at the time of neuraxial anesthesia placement didn't influence the mode of delivery, based on data from a study of 555 nulliparous women.

No previous study has addressed whether timing of neuraxial anesthesia with regard to the degree of the patient's pain has an impact on the mode of delivery, Dr. Yaakov Beilin said in a poster at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.

In this study, Dr. Beilin and Diana H. Mungall, both of Mount Sinai Hospital in New York, reviewed data from term, nulliparous women who presented to the labor floor of a single hospital between July 2005 and September 2008. Pain scores at the time of neuraxial analgesia placement were determined using a scale of 0-10 and divided into three groups: low (0-3), moderate (4-6), and high (7-10).

The cesarean section rate was 41%, 36%, and 34%, in the low-, moderate-, and high-pain groups, respectively; the differences were not significant.

Similarly, the operative delivery rate (which included cesarean plus instrumental assisted vaginal delivery) was 49%, 45%, and 45% in the low-, moderate-, and high-pain groups, respectively; these values were not significantly different. And the vaginal delivery rate of 51%, 55%, and 55% for the low-, moderate-, and high-pain groups, respectively, were not significantly different.

The results were limited by the retrospective nature of the study, but the data suggest that neuraxial analgesia can be safely placed in women with varying degrees of labor pain, Dr. Beilin said.

The researchers had no financial conflicts to disclose.

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