Introduction Of Neuraxial Labor Analgesia

2884 Words12 Pages
Synopsis: The introduction of neuraxial labor analgesia was associated with decreased cesarean delivery and episiotomy rates, and unchanged forceps rate in a large urban Chinese hospital. Abstract: Objective: The aim of this study was to evaluate the association between the introduction of neuraxial (epidural) labor analgesia and mode of delivery in a single large urban Chinese maternity hospital. Methods: The study was a single intervention impact study over a 25-month period (August 2009 – August 2011) including 19,938 deliveries (93% nulliparous) at the Shijiazhuang Obstetrics and Gynecology Hospital in Hebei province China. Mode of delivery, episiotomy rate, 7-day perinatal mortality and neonatal Apgar scores were compared…show more content…
Introduction: Neuraxial (epidural, spinal, and combined spinal-epidural) techniques are the most effective methods of pain relief during labor [ ]. In addition, physiologic benefits of neuraxial analgesia for the mother and fetus have been demonstrated [ - ]. Neuraxial labor analgesia use has progressively increased in the Western Hemisphere. In the United States, neuraxial labor analgesia for labor rose from 21% to 77% of parturients between 1981 and 2001 [ ]. In the United Kingdom, approximately 33% of parturients chose neuraxial analgesia in 2010 – 2011 [ ]. There are approximately 16.4 million deliveries in China per year [ ]; China has one of the highest cesarean delivery rates in the world (46.2%), and the greatest number of babies born by cesarean delivery. In a survey conducted in 2007 and 2008, the World Health Organization estimated that 11.7% of the approximately 2 million deliveries in China were cesarean deliveries without a medical indication [ ]. These non-medically indicated cesarean deliveries result in excess maternal morbidity and mortality [ ] as well as greater costs of medical care globally [ ]. One possible factor contributing to this high cesarean delivery rate is lack of readily available labor analgesia. Less than 1% of laboring women in China currently receive some type of labor analgesia [ ]. Despite the analgesic and physiologic benefits, the impact of neuraxial
Open Document