Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial

Gold, Lisa 2001, Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial, Lancet, vol. 358, no. 9275, pp. 19-23.

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Title Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial
Author(s) Gold, Lisa
Journal name Lancet
Volume number 358
Issue number 9275
Start page 19
End page 23
Publisher Lancet Publishing Group
Place of publication London, England
Publication date 2001-07-07
ISSN 0140-6736
1474-547X
Summary Background

Epidural analgesia is the most effective labour pain relief but is associated with increased rates of instrumental vaginal delivery and other effects, which might be related to the poor motor function associated with traditional epidural. New techniques that preserve motor function could reduce obstetric intervention. We did a randomised controlled trial to compare low-dose combined spinal epidural and low-dose infusion (mobile) techniques with traditional epidural technique.
Methods

Between Feb 1, 1999, and April 30, 2000, we randomly assigned 1054 nulliparous women requesting epidural pain relief to traditional (n=353), low-dose combined spinal epidural (n=351), or low-dose infusion epidural (n=350). Primary outcome was mode of delivery, and secondary outcomes were progress of labour, efficacy of procedure, and effect on neonates. We obtained data during labour and interviewed women postnatally.
Findings

The normal vaginal delivery rate was 35·1% in the traditional epidural group, 42·7% in the low-dose combined spinal group (odds ratio 1·38 [95% CI 1·01–1·89]; p=0·04); and 42·9% in the low-dose infusion group (1·39 [1·01–1·90]; p=0·04). These differences were accounted for by a reduction in instrumental vaginal delivery. Overall, 5 min APGAR scores of 7 or less were more frequent with low-dose technique. High-level resuscitation was more frequent in the low-dose infusion group.
Language eng
Field of Research 111402 Obstetrics and Gynaecology
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2001, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30006595

Document type: Journal Article
Collection: Faculty of Health
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