Abstract
There have been many publications about the association between the use of epidural analgesia during labor and labor outcomes. A fall in plasma oxytocin concentrations during labor with epidural analgesia and an increased use of oxytocin augmentation were reported. Although epidural analgesia has been reported to be associated with a longer first stage of labor, it is still controversial. Recent meta-analysis showed a longer second stage of labor and higher incidence of instrumental delivery in patients with epidural analgesia compared to those without it. However, they concluded that epidural analgesia does not increase the rates of cesarean delivery. It is suggested that a delay in the second stage is not harmful to the infant or mother provided that it is confirmed that the mother and fetus are doing well. Recent randomized trials made it clear that effective pain relief with regional anesthesia should not be withheld simply because an arbitrary degree of cervical dilatation has not yet been achieved.
