European Journal of Molecular & Clinical Medicine

Background: To assess efficacy of epidural bupivacaine and fentanyl for labour analgesia.
Materials and Methods: One hundred ten pregnant women primigravida and multigravida (ASA grade II) age ranged 18-30 years were recruited for this observational study. All patients were given first loading dose of 10 ml 0.25% plain bupivacaine via epidural catheter followed by continuous epidural infusion of 0.0625% bupivacaine with 2.5 mcg/ml fentanyl @ 12ml/hour. The parturients were assessed for hemodynamics, mode of delivery, VAS and APGAR (neonatal outcome).
Results: There were 42 Primigravida and 68 Multigravida. The mean visual analogue score before drug was 5.42 and after drug was 2.18. Mode of delivery was natural in 95, vacuum cup assisted in 14 and caesarean section in 1 case. Patient satisfaction score was excellent in 20 patients, good in 90 and poor in 0. The difference was significant (P< 0.05). At 1 minute, APGAR score 7 was seen in 4, score 8 in 45, score 9 in 55 and score 10 in 6 patients. At 5 minutes, score 9 was seen in 25 and score 10 in 85 patients. The difference was significant (P< 0.05).
Conclusion: Epidural labour analgesia with low dose bupivacaine (0.0625%) with fentanyl (2.5 mcg/ml), given through continuous infusion technique provides good pain relief to the parturient.

Background: Labour pain is among the maximum excruciating pain experienced by all women. Labour pain impacts maternal psychology and course of labour causing apprehension, tension, and strain. Pain relief throughout labour is predicted to lessen maternal strain and improve maternal and perinatal outcome. Many Nonpharmacological & Pharmacological methods of pain relief available. In this study we are comparing efficacy & safety of Paracetamol & Tramadol as labour analgesics.
Objective: To analyse the outcome of Programmed labour protocol vs expectant management of labour with respect to
1. Mean rate of cervical dilatation.
2. Mean duration of first, second, third stage of labour.
3. Pain relief in labour.
4. Mode of Delivery.
5. APGAR scores at 1min and 5min.
Methods: All women admitted in the labour room, meeting the inclusion criteria and willing to participate in study are categorized into group A and group B.
Programmed labor group(A) and expectant group. (B)
The study group A includes primigravida at term in active phase. Admitted in labor who will receive Programmed labor protocol. And group B will be managed expectantly.
After obtaining informed consent all women willing to participate will be examined according to protocol.
Results: In our study both the groups were comparable in relation to age, gestational weeks and cervical dilatation. Most common mode of delivery was vaginal in both the groups. Duration of first stage of labour and second stage of labour is significantly reduced compared to control group. Pain relief scoring in study group moderate to complete pain relief is 85.7%.
Mean cervical dilatation among the study group was 2 cm/hour which is higher compared to the control group (1 cm/hour). In study group-11.5% underwent LSCS which is lesser compared to the control group (15.5%). All the babies had Apgar score of 7-9 at one and five minutes. 4babies in the control group had Apgar score of six at one minute and on resuscitation, they had Apgar score of 8-9 at 5 minutes. Mean Apgar of the babies at one and five minutes in both the groups were comparable.
Conclusion: Programmed labor is an easier, safer means for ensuring less painful delivery. It reduces the duration of the labour without serious maternal and neonatal side effects. Pain relief is effective with minimal maternal side effects due to the drugs used. Labour and childbirth are cherished by the mother and her family. It can be adapted safely in all Maternity hospitals in low risk gravid woman.