Author/Editor		Markova, Liljana; Lučovnik, Miha; Verdenik, Ivan; Stopar Pintarič, Tatjana
Title		Delivery mode and neonatal morbidity after remifentanil-PCA or epidural analgesia using the Ten Groups Classification System
Type		članek
Vol. and No.		, št. Vol. 277
Publication year		2022
Volume		str. 53-56
ISSN		1872-7654 - European journal of obstetrics, gynecology, and reproductive biology
Language		eng
Abstract		(RPCA) or epidural analgesia (EA), and caesarean section (CS) rate, operative vaginal delivery rate (OVD), operative delivery (OD) rate (CS or OVD) with pathological cardiotocography (CTG) tracing, Apgar score < 7 at 5 min after birth, incidence of perinatal asphyxia and neonatal intensive care unit (NICU) admission within four groups of the Ten Groups Classification System (TGCS) labour types; group 1: nulliparous, singleton cephalic, s37 weeks, spontaneous onset of labour; group 2a: nulliparous, singleton cephalic, s37 weeks, induction of labour; group 3: multiparous, singleton cephalic, s37 weeks, spontaneous onset of labour; group 4a: multipara, singleton cephalic, s37 weeks, induction of labour). We hypothesized that labour and delivery outcomes between RPCA and EA would differ within the different TGCS labour types. Study design: 10,561 deliveries (4876 with RPCA, 5685 with EA) at the University Clinical Centre Ljubljana, Slovenia, from 2015 through 2019 were analysed using the Slovenian National Perinatal Information System data. Results: Compared to EA, RPCA was associated with lower CS and OVD rates in nulliparous women with spontaneous onset of labour (group 1) (CS: 9.9 % vs14.3 %; P < 0.001) (OVD: 5.1 % vs 8.4 %; P < 0.001), in nulliparous women with induced labour (group 2a) (CS: 14.8 % vs 24.2 %; P < 0.001) (OVD: 6.5 % vs 8.9 %; P = 0.036) and in multiparous women with spontaneous onset of labour (group 3) (CS: 1.1 % vs 2.4 %; P = 0.021) (OVD: 0.1 % vs 0.8 %; P = 0.007), respectively. RPCA was associated with a lower incidence of OD with pathologic CTG in all four studied groups (groups 1, 2a, 3, 4a). No differences in APGAR < 7 at 5 min, neonatal asphyxia, and NICU admission were recorded between the two analgesic techniques within any of the TGCS groups. Conclusion: Compared to EA, RPCA was not associated with worse delivery and neonatal outcomes within any of the four studied TGCS groups. RPCA could be used for labour analgesia routinely if strict adherence to protocols is ensured and regular staff training is provided.
Keywords		porodna analgezija klasifikacijski sistem desetih skupin epiduralna analgezija labour analgesia ten group classification system epidural analgesia