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Low-dose mobile epidurals boost vaginal births. (Study Compares Low and High Doses).
HILTON HEAD, S.C. - Women who have low-dose "mobile" epidurals may itch a bit more, but they're also more likely to have spontaneous vaginal deliveries than are women who have traditional, high-dose neuraxial analgesia, Dr. Pamela Angle said.
The findings of her metaanalysis lend more weight to the notion that so-called mobile epidurals, which use low doses of analgesia to preserve motor function, reduce the odds of a woman requiring an instrumental delivery. Still, low-dose epidurals don't make much of a dent in cesarean section rates, Dr. Angle said in a poster presentation at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
After conducting a search of the literature published between 1980 and 2001, Dr. Angle of the Sunnybrook & Women's College, Toronto, and her colleagues identified four randomized, controlled trials comparing mobile and traditional epidurals and involving a total of nearly 2,100 patients. All trials compared the modes of delivery from low- and high-dose epidural using bupivacaine only.
The odds of having an instrumental delivery were lower in the low-dose group ...
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