Pregnancy Clinical Trial
Official title:
A Retrospective Case-controlled Study of the Association Between Request to Discontinue Second Stage Labor Epidural Analgesia and Risk of Instrumental Vaginal Delivery
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.
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.
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Observational Model: Case Control, Time Perspective: Retrospective
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