Effect of segmental epidural block on the course of labour and the condition of the infant during the neonatal period.

Epidural block for vaginal delivery was given to 242 women during a 6-month period. Of these, 178 with a spontaneous start of labour and vaginal delivery were studied with respect to the effect of epidural block with bupivacaine-adrenaline on the course of labour and the condition of the infant in women with normal uterine activity and women with primary uterine inertia treated with oxytocin infusion. On average, the 178 women had already had a longer course of labour before the block was applied than women in control groups. The block per se had only a slight effect on the first stage of labour, but the effect on the second stage was more obvious, leading to outlet extraction in 50% of the primiparous women, compared to 12% of the controls. Transitory asphyxia at birth was observed in 4.5% of the infants of mothers with epidural block, but after 5 min, only 1% had an Apgar score of less than 7. Infants of mothers with epidural block were more often placed under observation or treated in the neonatal ward than infants in control groups.