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Epidural analgesia does not prolong the third stage of labour

[L’analgésie épidurale ne prolonge pas la délivrance lors de l’accouchement]

From the Department of Anesthesiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.

Address correspondence to: Dr. Ola P. Rosaeg, Department of Anesthesiology, B3, The Ottawa Hospital – Civic Campus, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada. Phone 613-761-4169; Fax: 613-761-5209; E-mail: norse{at}cyberus.ca

Purpose: To investigate whether there is an association between epidural analgesia and duration of third stage of labour, and between epidural analgesia and type of placental delivery (spontaneous vs expressed vs manual).

Methods: We examined, retrospectively, the computerized labour and delivery data of all 7,468 parturients who had vaginal deliveries from 1996 to 1999 at the Civic Campus of the Ottawa Hospital.

Results: There was no difference in duration of third stage of labour between women with and without epidural pain relief who had spontaneous or expressed (fundal pressure/gentle cord traction) placental delivery. Duration of third stage of labour was shorter in women with epidural analgesia requiring manual removal of placenta. (25.3 min vs 40.1 min, P < 0.0001). The incidence of expressed placental delivery or manual removal of placenta was not different between the groups.

Conclusions: We conclude that there is no clinically important difference in duration of third stage of labour between women with or without epidural analgesia who have spontaneous placental delivery or placental expulsion with fundal pressure/gentle cord traction. However, duration of third stage of labour was shorter in women who received epidural analgesia and required manual removal of the placenta.