A Preliminary Experience of Maternal Request for Epidural Labour Analgesia and Outcome in a Nigerian Tertiary Hospital

Abstract

Introduction: Maternal request is an indication for epidural labour analgesia (ELA), the gold standard for pain relief in labour, based on United Kingdom Obstetric guidelines. This study aimed to assess the outcome of our Institutional protocol of encouraging women in labour to request for ELA.

Methodology: This is a prospective study conducted among 51 women who requested for epidural analgesia at presentation in labour. The Epidural group received ELA when they were in labour and the non-epidural group did not receive it. The variables measured were modes of delivery and neonatal outcomes using Apgar scores which were compared in the two groups. We also reviewed the reasons for not receiving ELA in the non-epidural group.

Results: Thirty-six (70.6%) mothers received ELA and 15 (29.4%) did not out of 51. Twenty-nine mothers (80.6%) in the Epidural group versus 13 (86.7%) in the Non-epidural group had spontaneous vertex delivery (p₌0.195)   and 7 (19.4%) babies had neonatal admissions in the epidural group compared to 1 (6.7%) in the non-epidural group respectively (p₌0.58). In non-epidural group, the reasons attributed for not giving ELA by the anaesthetists were busy duty hours 7 (40%), late request 4 (26.7%), unaffordable cost 2 (13.3%), precipitous labour 2 (13.3%) and failed attempt 1 (5.9%)

Conclusion: Most of the parturients that requested for ELA received it with reasonable outcome. However, busy duty hour was the major reason for not receiving ELA in those that requested but did not receive.

Key words: Busy hours; foetal outcome; labour analgesia; maternal epidural request; maternal outcome