Is epidural analgesia during labor related to retained placenta?
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Avraham Sarit
Abstract
Objectives: To explore the influence of epidural analgesia on the course of the third stage of labor and on the incidence of the complete retained placenta as well as retained parts of the placenta.
Study design: This is a population-based cohort study in a tertiary medical center. We collected data from all 4227 spontaneous singleton vaginal deliveries during 6 months and compared the incidence of retained placenta in deliveries with epidural analgesia with those without analgesia. Multivariable logistic regression was used to control for possible confounders.
Results: More than two-thirds of the women (69.25%) used epidural analgesia during their delivery. A need for intervention due to placental disorder during the third stage of labor was noted in 4.2% of all deliveries. Epidural analgesia appeared to be significantly (P=0.028) related to placental disorders compared with no analgesia: 4.8% vs. 3%, respectively. Deliveries with manual interventions during the third stage, for either complete retained placenta or suspected retained parts of the placenta, were associated with the use of epidural analgesia (P=0.008), oxytocin (P=0.002) and older age at delivery (P=0.000), but when including all factors in a multivariable analysis, using a stepwise logistic regression, the factors that were independently associated with interventions for placental disruption during the third stage of delivery were previous cesarean section, oxytocin use and, marginally, older age.
Conclusions: Complete retained placenta and retained parts of the placenta share the same risk factors. Epidural analgesia does not directly influence the incidence of complete retained placenta or retained parts, though clinically linked through increased oxytocin use. The factors that were independently associated with interventions for placental disruption during the third stage of delivery were previous cesarean section, oxytocin use and older age.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2016 by De Gruyter
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Obesity and gestational diabetes in pregnancy: an evolving epidemic
- Original articles - Diabetes
- Is omitting the 3rd hour measurement in the 100 g oral glucose tolerance test feasible?
- Maternal hypoglycemia on 50 g glucose challenge test: outcomes are influenced by fetal gender
- Biological and biochemical characteristics of a Mediterranean population with Gestational Diabetes Mellitus
- Maternal and perinatal outcomes after bariatric surgery: a case control study
- A population-based comparison between actual maternal weight gain and the Institute of Medicine weight gain recommendations in singleton pregnancies
- The relationship between cesarean section rate in term singleton pregnancies, maternal weight, and weight gain during pregnancy
- Antenatal body mass index (BMI) and weight gain in pregnancy – its association with pregnancy and birthing complications
- A clinical study which relates to a theoretical simulation of the glucose transport in the human placenta under various diabetic conditions
- Academy’s Corner
- American medical education: the evolution of excellence
- Original articles - Obstetrics
- Is epidural analgesia during labor related to retained placenta?
- Preventing intellectual disability during pregnancy: what are the potentially high yield targets?
- Evaluation of measured postpartum blood loss after vaginal delivery using a collector bag in relation to postpartum hemorrhage management strategies: a prospective observational study
- Original articles - Fetus
- Mutation analysis and prenatal diagnosis in a Chinese family with succinic semialdehyde dehydrogenase and a systematic review of the literature of reported ALDH5A1 mutations
- Original articles - Newborn
- Neurological disease or intellectual disability among sons of female Swedish dental personnel
- Seeking the best training model for difficult conversations in neonatology
- Meconium aspiration syndrome in infants of HIV-positive women: a case-control study
- Dopamine treatment does not need speed recovery of newborns from transient tachypnea
- Congress Calendar
- Congress Calendar
