1. Spinal analgesia for relief of labour pain
in prima- and multiparous women
Evija Austruma1 and Jonas Åkeson2
Departments of 1Anaesthesiology and Intensive Care Medicine, Central Hospital, Kristianstad, and of 2Anaesthesiology and Intensive Care Medicine, Skåne University Hospital and Lund University, Malmö, Sweden
CONCLUSIONS
Primaparous mothers have higher risks for instrumental delivery and intrapartum Caesarean section, but spinal analgesia for labour pain is similarly effective in primaparous and multi-parous women.
AIMS
RESULTS
This descriptive study was designed to analyze effects and adverse effects of spinal analgesia for relief of labour pain in prima- and multiparous women.
Compared with multiparous mothers, primaparous mothers were more often subjected to instrumental delivery (17% vs. 3.7%; P=0.0086) and intrapartum Caesarean section (7.3% vs. 0%; P=0.0142), but there were no significant differences in incidence of maternal hypotension, postdural puncture headache, use of epidural blood patch, third- or fourth-degree perineal tear or potential adverse effects on the infant. No significant differences were found in maternal satis-faction with the pain relief or use of supple-mentary regional analgesia.
PATIENTS AND METHODS
The retrospective study design was ap-proved by the regional Human Research Ethics Review Board, Lund, Sweden (DNR 2015/687). We included 164 obstetrical patients (82 prima- and 82 multiparous women) given spinal analgesia with 10 µg of sufentanil for labour pain. Intrahospital maternal hypotension, postdural puncture headache, use of epidural blood patch, third- or fourth-degree perineal tear, intrapartum Caesarean section, abnormal foetal heart rate, low Apgar score, neonatal or intensive care, and breastfeeding problems were recorded. Outcome measures were maternal satisfaction with pain relief, and need for supplementary analgesia. Statistical ana-lyses were made with two-tailed unpaired student’s t-test and Fischer’s exact test. Probability (P) levels <0.05 were considered statistically significant.
Maternal and foetal
outcome measures
Number of primaparos
mothers
(n=82)
Number of multiparous
Statistical probability (P) level
Maternal hypotension 1
>0.300
Foetal bradycardia 3 2
Late foetal deceleration 10 5
0.190
Use of vacuum extraction 13
0.0091
Use of forceps
Episiotomy
3rd/4th-degree perineal tear
Intrapartum Caesarean section 6
0.0142
Apgar score ≤7 at 1 min 7
0.213
Apgar score ≤7 at 5 min
0.248
Use of neonatal care
0.280
Use of spinal analgesia
Use of epidural analgesia 4
Use of other regional analgesia 9
0.163
Analgesia rated good/very good 82
Accidental dural puncture
Postdural puncture headache
Use of epidural blood patch
References
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