To determine if epidural analgesia is associated with differences in rates of severe perineal trauma during vaginal deliveries.
We studied 1942 consecutive, low-risk, term, vaginal deliveries in nulliparas, including spontaneous and induced labors, at a single institution from December 1994 to August 1995.
The rate of third-and fourth-degree lacerations was compared for women who had and did not have epidural analgesia for labor-pain relief.
Statistical significance was determined using X2.
Logistic regression analyses were used to evaluate associations while controlling for possible confounding variables.
Overall rates of third-and fourth-degree lacerations were 10.8% (n=210) and 3.4% (n=63), respectively.
Epidural analgesia was given to 1376 (70.9%) women.
Among women who had epidurals, 16.1% (221 of 1376) had severe perineal lacerations compared with 9.7% (n=55) of the 566 women who did not have epidurals (P<. 001 ; odds ratio [OR] 1.8,95% confidence interval [CI] 1.3,2.4).
When controlling for birth weight, use of oxytocin, and maternal age in logistic regression analysis, epidural remained a significant predictor of severe perineal injury (OR 1.4,95% CI 1.0,2.0). (...)
Mots-clés Pascal : Analgésie, Extradural, Accouchement, Délivrance, Voie vaginale, Nulliparité, Déchirure, Périnée, Epidémiologie, Facteur risque, Homme, Femelle, Etats Unis, Amérique du Nord, Amérique, Traumatisme
Mots-clés Pascal anglais : Analgesia, Extradural, Delivery, Third stage labor, Vaginal route, Nulliparity, Break, Perineum, Epidemiology, Risk factor, Human, Female, United States, North America, America, Trauma
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0417756
Code Inist : 002B20G02. Création : 22/03/2000.