Continuing epidural analgesia during the second stage and ACOG definition of arrest of labor on maternal–fetal outcomes
Acta Anaesthesiologica Scandinavica Apr 28, 2020
Zheng SX, Zheng W, Zhu T, et al. - Although rates of epidural labor analgesia have increased, interruption in continuation of epidural labor analgesia in the second stage of labor (CEADSSOL) was made by care providers due to fears of raised risk of operative delivery and adverse neonatal outcomes. Hence, they examined how CEADSSOL and the newer American College of Obstetricians and Gynecologists(ACOG) definition of arrest of labor affect the length of secondary stage of labor, newborn outcomes and mode of delivery. For this retrospective cohort study, collection of data began in March 2014 and ended in May 2015, one year postimplementation of both interventions. The length of secondary stage of labor, mode of delivery and neonatal outcome (Apgar <7, at 5 min) were assessed as the primary outcomes. The implementation of continuing epidural analgesia during the second stage of labor with 0.08‐0.15% ropivacaine and sufentanil 0.1‐0.2 mcg/mL. During the study period, a total 10,414 deliveries were reported. The groups did not exhibit significant differences in length of the second stage of labor. Findings revealed improvement in neonatal outcomes in correlation with implementation of two jointed interventions without a cost of increased operative delivery.
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