Impact of epidural analgesia on cesarean and operative vaginal delivery rates classified by the Ten Groups Classification System

• Published in: International journal of obstetric anesthesia Vol. 34; pp. 37 - 41
• Main Authors: Lucovnik, M., Blajic, I., Verdenik, I., Mirkovic, T., Stopar Pintaric, T.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-05-2018
• Subjects: Assisted vaginal delivery; Cesarean delivery; Epidural analgesia; The Ten Group Classification System; Cesarean delivery; Assisted vaginal delivery; The Ten Group Classification System; Epidural analgesia
• ISSN: 0959-289X; 1532-3374
• DOI: 10.1016/j.ijoa.2018.01.003

•Ten Groups Classification System classifies women based on obstetric characteristics.•In most TGCS groups, women with epidural analgesia had lower cesarean rates.•Women in TGCS group 1, with epidural analgesia, had a higher rate.•In most groups, women with epidural analgesia had higher vacuum delivery rates.
The Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS.
Slovenian National Perinatal Information System data for the period 2007–2014 were analyzed. All women after spontaneous onset or induction of labor were classified according to the TGCS, within which cesarean and vaginal assisted delivery rates were investigated (P <0.003 significant).
Data on 207 525 deliveries (and 211 197 neonates) were analyzed. In most TGCS groups women with epidural analgesia had lower cesarean delivery rates. Women in group 1 (nulliparous term women with singleton fetuses in cephalic presentation in spontaneous labor) with epidural analgesia had a higher cesarean delivery rate. In most TGCS groups women with epidural analgesia had higher assisted vaginal delivery rates.
Epidural analgesia is associated with different effects on cesarean delivery and assisted vaginal delivery rates in different TGCS groups.