Impact of walking epidural analgesia on obstetric outcome of nulliparous women in spontaneous labour

Background

To explore the effects of walking epidural analgesia on obstetric and neonatal outcomes, we performed a case-control study.

Method

Each nulliparous woman receiving walking epidural analgesia using 0.0625% bupivacaine (n=44) was matched to two nulliparous historical controls receiving 0.125% or 0.25% bupivacaine (n=88 each) for epidural analgesia while recumbent.

Results

Maternal and obstetric parameters, fetal status and presentation, and oxytocin use were comparable among groups. Those receiving walking epidural analgesia walked for a mean of 60 min (range: 20-75 min). In the control groups the mean total durations of labour were shorter (58 min in the 0.125% group and 99 min in the 0.25% group, P<0.05). Significantly fewer walking epidural analgesia cases than controls required instrumental vaginal delivery (P<0.05). No other differences in obstetric or fetal outcome were observed and no mother fell or stumbled while walking.

Conclusion

Although it was associated with a prolonged first stage of labour, walking epidural analgesia appeared safe for nulliparous women and their babies.

Keywords: Walking epidural analgesia, Obstetrics, Labour