Influence of combined spinal epidural analgesia and epidural analgesia on the progress of labor,delivery way and mothers and infants outcome

Objective To study whether combined spinal-epidural analgesia(CSEA)and patient-control epidural analgesia(PCEA)has influence on labor progress,delivery way and mothers and infants outcome.Methods Cases data of 406 healthy nulliparas were retrospectively analyzed,study group(345 cases)accepted CSEA+PCEA and control group(282 cases)without CSEA+PCEA,to compare the labor progress,delivery way and the maternal and fetal outcome.Results The duration of active phase in the first stage and the second stage in the study group[(223.33 ±105.85)min,(59.29 ±33.155)min]were significantly longer than that of control group[(176.14±99.66)min,(46.71±33.69)]min(P0.01),the rate of augmentation by oxytocin and the occurrence of arrested active phase in the study group(60.00%,6.67%)were significantly higher than that of control group(27.68%,2.34%)(P0.001,P=0.034),The rate of cesarean section and urinary retention during labor in the study group(11.85%、55.56%)were significantly higher than that of control group(5.54%,33.58%)(P=0.024,P0.001),No statistical difference was found between the two groups in the rate of dystocia(forceps delivery and cesarean section),amniotic fluid changes,the duration of the third stage,the incidence of postpartum hemorrhage,the Apgar score of newborn,the occurrence of neonatal asphyxia and postpartum urine retention.Conclusion CSEA+PCEA had adverse effect on labor progress,but it has no evident adverse effect on delivery way and mothers and infants outcome in the near future.