The Outcome Analysis Of Epidural Analgesia On Labor In Primigravida Women:a Systematic Review And Meta-analysis Focusing On Duration Of Labor

BACKGROUND: Epidural anesthesia is extensively used worldwide for pain relief in labor and more lately as an alternative and preferred form of anesthesia for caesarean sections;although its use is gaining universality,its outcome on the duration of labor is still debatable.Our meta-analysis aimed at analyzing the effects of epidural analgesia on duration of labor in primigravid women focusing on duration of labor.METHODS: We conducted a systematical literature search in Pub Med and Embase(from the inception to July 2016).We calculated weighted mean differences(WMD)between the groups for continuous data,and corresponding 95% confidence intervals(CIs)using the random-effects model.We also performed a subgroup analysis for the effects of different types of studies on duration of labor.Statistical heterogeneity amongst the included studies was tested by I2 indicator.RESULTS: Twelve studies,recruiting 16200 mothers overall,were selected for this systematic review and meta-analysis.The duration of first stage of labor was significantly prolonged in the no epidural group by a mean of 2.66(0.89,4.43,P=0.003)and significantly shortened the second stage of labor by a mean of-12.79(-21.13,-4.45,P=0.003).Moreover,the overall subgroup analyses shown significantly prolongation of the first stage of labor by the same mean of 2.66(0.89,4.43,P=0.003).CONCLUSION: The use of epidural analgesia for pain relief during labor is not associated with prolongation of first and second stages of labor in the groups of patients who requested epidural analgesia for pain relief during normal vaginal delivery.