Effects of different analgesic methods used for vaginal delivery on mothers and fetuses

Abstract

Background/aim: Knowledge regarding pain relief during labor remains insufficient. We aimed to determine and compare theeffectiveness and safety of epidural analgesia, combined spinal–epidural analgesia, and parenteral meperidine on both mothers andfetuses.Materials and methods: This study was designed as an observational case-control study. We collected prospective data from patientswhose labor pain management was conducted with meperidine in addition to retrospective cohort data of neuraxial methods; 138patients were enrolled. Epidural analgesia group consisted of 68 patients, whereas combined spinal-epidural (CSE) analgesia group andmeperidine group consisted of 50 and 20 patients, respectively. We compared the delivery patterns, labor durations, pain levels, sideeffects, maternal satisfaction levels, and neonatal outcomes of the various pain management methods.Results: Patient demographics, duration of first, second, and third labor stages, and instrumental delivery rates were comparable amonggroups (P > 0.05). Cesarean section tended to be less frequent in the CSE group. In the meperidine group, visual analog scale (VAS)values and sedation were significantly higher (P < 0.001) and maternal satisfaction lower (P < 0.001). Hypotension tended to be morefrequent in the meperidine group. APGAR scores at the 1st and 5th min were similar among the groups and between meperidinesubgroups defined by three different administration times ( 0.05).Conclusion: Neuraxial methods had no effect on instrumental delivery rates. CSE represented a near significant risk reduction incesarean section. Our results demonstrated that regional analgesia methods were reasonably safe for both mother and fetus, and regionalanalgesia methods resulted in greater maternal satisfaction and pain control compared to meperidine.