The Effects of Labour Neuraxial Analgesia Used on Maternal and Neonatal Outcomes
Outcomes using Labour Central Neuraxial Analgesia
Abstract
The effect of types of labour central neuraxial (CN) technique used on maternal mode of delivery (MOD) and neonatal Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score were evaluated. Data of 1378 parturients who were aged ≥18 with singleton pregnancy at term (≥37 and ≤42 weeks’ gestation) and received labour CN analgesia were retrospectively reviewed. Their demographic data, types of CN technique used, maternal MOD and neonatal APGAR score were recorded. Labour CN techniques were performed in 19.36% parturients which mostly was epidural technique (16.76%). Parturients who used combined spinal epidural (CSE) technique for labour analgesia had more instrumental deliveries (IDs) compared to using epidural technique (22 (22.4%) vs. 76 (77.6%), p=0.011). Parturients who used CSE technique for labour analgesia had an increased likelihood of IDs by 2.044 (95% CI 1.186-3.253, p=0.01) and parturients who were nulliparous had higher risk by 2.110 (95% CI 1.299-3.249, p=0.03). The types of labour CN technique used did not affect the neonatal APGAR scores (APGAR score: Good [epidural 1182 (99.6%) vs. CSE 189 (99%) and Bad [epidural 5 (0.4%) vs. CSE 2 (1.0%)], p=0.252). In conclusion, the types of labour CN technique used affected the maternal MOD without affecting the neonatal outcome.
Keywords :
Combined spinal epidural,
epidural,
labour analgesia,
Abstrak
Kesan jenis teknik sentral neuraksial (CN) yang digunakan semasa bersalin terhadap cara kelahiran ibu (MOD) dan skor 'Appearance, Pulse, Grimace, Activity and Respiration' (APGAR) neonatal telah dinilai. Data daripada 1378 ibu bersalin yang berumur ≥18 dengan kehamilan tunggal pada tempoh matang (≥37 dan ≤42 minggu kehamilan) dan menerima analgesia CN ketika bersalin telah dikaji secara retrospektif. Data demografi, jenis teknik CN yang digunakan, MOD ibu dan skor APGAR neonatal telah direkodkan. Teknik CN digunakan dalam 19.36% ibu ketika bersalin dan kebanyakannya adalah teknik epidural (16.76%). Ibu yang menggunakan teknik gabungan spinal epidural (CSE) untuk analgesia semasa bersalin mempunyai lebih banyak kelahiran instrumental (IDs) berbanding dengan menggunakan teknik epidural (22 (22.4%) berbanding 76 (77.6%), p=0.011). Ibu yang menggunakan teknik CSE untuk analgesia semasa bersalin mempunyai kemungkinan peningkatan ID sebanyak 2.044 (95% CI 1.186-3.253, p=0.01) dan risiko parturient yang nulipara meningkat sebanyak 2.110 (95% CI 1.299 3.249, p=0.03). Jenis teknik CN yang digunakan ketika bersalin tidak mempengaruhi skor APGAR neonatal (skor APGAR: Baik [epidural 1182 (99.6%) berbanding CSE 189 (99%) dan Buruk [epidural 5 (0.4%) vs. CSE 2 (1.0% )], p=0.252). Kesimpulannya, jenis teknik CN yang digunakan ketika bersalin mempengaruhi MOD ibu tanpa memberi kesan pada neonatal.
Kata Kunci :
Analgesia semasa bersalin,
epidural,
gabungan spinal epidural,
Correspondance Address
Associate Professor Dato’ Dr. Wan Rahiza Wan Mat. Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +60192787493 Email: docaweng@yahoo.com
