[Influence of combined spinal-epidural analgesia and epidural analgesia on the progress of labor]

To investigate the influence of combined spinal-epidural analgesia (CSEA) and epidural analgesia (EA) and patient-controlled epidural analgesia (PCEA) on labor progress.The partograms of 722 healthy vaginal delivery nulliparas were retrospectively analyzed in Department of Obstetric and Gynecology, First Hospital of Peking University. Three groups were divided among all subjects: CSEA group (259 cases) receiving CSEA + PCEA, EA group (215 cases) receiving EA + PCEA and control group (248 cases) without any analgesia method.The duration of active phase in the first stage and the second stage in the CSEA group [(272 +/- 127) min and (57 +/- 36) min] and in the EA group [(305 +/- 133) min and (59 +/- 39) min] were significantly longer than that of control group [(188 +/- 110) min and (45 +/- 32) min]. No significant difference was found in the three groups in the duration of the third stage [CSEA: (9 +/- 6) min; EA: (8 +/- 6) min;(9 +/- 6) min. P0.05]. The dilatation curve of the cervix in CSEA group and EA group was plotted on the right side of the Friedman curve while that of the control group on the left, reflecting a slower progress in the former two groups than the control during the active phase. The average speed of cervical dilatation in CSEA and EA groups (1.5 cm and 1.4 cm) was significantly slower than that of the control (1.8 cm) in the active phase (P0.01).CSEA + PCEA or EA + PCEA during labor might slow down the progress of the active phase and lead to a prolonged labor in the end. Therefore, the management of these parturients may vary based on Friedman partogram.