The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps Delivery

Northwestern University

Status: Completed

Conditions: Labor Pain; Pregnancy

Treatments: Other: Case controlled analysis of epidural labor analgesia patterns

Study type: Observational

Funder types: Other

Identifiers

NCT00443560

0524-028

Details and patient eligibility

About

The objective of this study will be to compare epidural infusion management, specifically looking at infusion rate changes, in patients who receive forceps deliveries versus normal spontaneous vaginal deliveries. We will match patients based on time and date of delivery, as well as parity, in order to eliminate these variables as potential con-founders.

We hypothesize patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery.

Full description

The obstetrical anesthesia database will be queried for all forceps deliveries between the dates of January 2004-October 2005. To minimize the influence of different anesthetic and obstetric care providers, the control group consisted of parturients who has spontaneous vaginal deliveries (SVD) in the same 24 hour period who were case-matched for gravidity and parity. Parturients with twin deliveries and fetal demise were not selected for either group.

The database will be queried for the following: maternal age, parity, gestational age, type of analgesia, changes in epidural infusion rate and/or concentration, and supplemental bolus doses of local anesthesia. The data will be stripped of identification by the database manager and entered into a secured computer which is password protected and maintained in the Department of Anesthesiology. The primary endpoint is to evaluate if decreasing the epidural infusion rate was associated with a forceps delivery.

Enrollment: 2,162 patients

Sex: Female

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Singletons
• Viable fetal vaginal deliveries between January 2004-October 2005

Exclusion criteria

• Outside specified time frame
• Multiparity
• Fetal demise

Trial design

2,162 participants in 2 patient groups

Instrumental Vaginal Delivery (IVD)

Description:

Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.

Treatment:

Other: Case controlled analysis of epidural labor analgesia patterns

Spontaneous Vaginal Delivery (SVD)

Description:

The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.

Treatment:

Other: Case controlled analysis of epidural labor analgesia patterns