OUTCOME OF EPIDURAL ANALGESIA IN PRIMIGRAVIDA

Aim: To evaluate the effect of epidural analgesia in primigravida on maternal and fetal outcomes on these parameters - Duration and progress of labor, Mode of delivery (Spontaneous/Instrumental/Operative), Apgar score of newborn, Untoward reaction and intra - partum complications followin g epidural analgesia. Materials and Methods: This was a prospective study of forty primigravida admitted with latent labor at Al - Ameen Medical College Hospital Bijapur during the period October 2013 to October 2014. On admission to labor room general and Systemic examination along with per abdominal and per vaginum examination was done on admission. Routine in vestigations were carried out. Epidural analgesia was administered once patient entered active phase of labor. Maternal and fetal outcomes were noted . Results: Majority (88%) women were between 20 - 25 years of age. 55% of babies had expected fetal weight in range of 2000 - 2500 gms . Mean duration of active first stage of labor was 361.54 + 52.39 minutes, mean duration of second stage of labor was 71.84 + 14.86 minutes. 38(95%) patients had excellent analgesia. 36(90%) patients had no motor blockade. 23(58%) patients had a normal delivery, 15 (37%) had instrumental delivery while only 2(5%) had caesarean section. Maximum number of instrumental deliveries were due to insufficient maternal efforts. 11 (28%) neonates had Apgar score of less than seven at one minute and none with Apgar score of less than seven at five minutes. Maternal complications were few. Conclusion: Epidural analgesia is safe and effective for satisfactory pain relief to parturient women. However, the second stage of labor may be prolonged due to insufficient maternal efforts necessitating instr umental delivery .