The safety of epidural analgesia in labour and its effect on delivery--a case control study in Pakistani women.

To assess the safety and effect of epidural analgesia on the course of labour and delivery in Pakistani women, a retrospective case control study was conducted from November, 1986 to November, 1991 (5 years) at the Aga Khan University Medical Centre, Karachi. All patients (n = 64) who received epidural analgesia for labour (cases) were compared with randomly selected patients (n = 18) who did not receive epidural analgesia during labour (controls). The cases and controls were matched for age, height, body mass index, parity, use of oxytocin, presentation and weight of the foetus. There was no significant difference (P > 0.05) between the two groups in duration of labour, caesarean section rate and foetal apgar scores at 1 and 5 minutes after birth. The incidence of malposition of foetal vertex at delivery and that of instrumental (forceps) deliveries was significantly higher (P < 0.05 and < 0.01 respectively) in the epidural group as compared to controls. The incidence of complications was low and the acceptance and tolerance of epidural analgesia was good in our patients.