• Anjel Vahratian, Jun Zhang, Jill Hasling, James F Troendle, Mark A Klebanoff, and John M Thorp.
• Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
• Am. J. Obstet. Gynecol. 2004 Jul 1;191(1):259-65.

ObjectiveThe purpose of this study was to compare the effect of early epidural with the use of early intravenous analgesia on labor progression.Study DesignWe systematically selected singleton, nulliparous term pregnancies with a spontaneous labor and analgesia placement ResultsAfter adjustment had been made for confounders, women in the after period had a slower labor progression only from 4 to 5 cm, compared with those women in the before period. Interestingly, the process of labor admission and epidural analgesia placement, rather than analgesia use per se, appeared to explain most of the slowdown. No significant difference in the rest of the active phase was observed between the 2 groups.ConclusionOur data support recent American College of Obstetricians and Gynecologists guidelines that the restraining use of epidural analgesia at <4 cm of cervical dilation is unnecessary.

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