October 10, 2014 — Pregnant women who choose to receive pain relief via an epidural during labor and delivery should be able to decide when the epidural is administered, according to a formal research review recently published by the Cochrane Library, Reuters reports.
For the review, a research team led by Singapore-based KK Women's and Children's Hospital's Ban Leong Sng reviewed clinical trials that randomly assigned around 16,000 women to have epidurals administered during early or late stages of labor. According to Reuters, the researchers considered epidurals early if administered when the patient's cervix was dilated no more than four to five centimeters, while late epidurals were those administered when the cervix was dilated more than five centimeters.
According to Reuters, earlier studies have warned that administering an epidural early in labor could prolong labor or increase the risk of a cesarean section. However, the new review found that duration of labor and the risk of surgical intervention did not vary between women who had received early or late epidurals.
The researchers concluded "that it would appear to be advantageous to initiate epidural analgesia for labor early, when requested by the woman." They added that the findings are in tandem with recommendations made by the American College of Obstetricians and Gynecologists (Seaman, Reuters, 10/8).