BJOG : an international journal of obstetrics and gynaecology
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Review Meta Analysis Comparative Study
Analgesia in labour and fetal acid-base balance: a meta-analysis comparing epidural with systemic opioid analgesia.
To assess the effect of epidural versus systemic labour analgesia on funic acid-base status at birth. ⋯ Umbilical artery pH is influenced by maternal hyperventilation. Base excess is therefore a better index of metabolic acidosis after labour. Epidural analgesia is associated with improved neonatal acid-base status, suggesting that placental exchange is well preserved in association with maternal sympathetic blockade and good analgesia. Although epidural analgesia may cause maternal hypotension and fever, longer second stage of labour and more instrumental vaginal deliveries, these potentially adverse factors appear to be outweighed by benefits to neonatal acid-base status.