Delayed pushing with lumbar epidural in labour-does it increase the incidence of spontaneous delivery?

SummaryForty-one women with effective lumbar epidural analgesia were allocated at random to either early or delayed pushing upon diagnosis of full cervical dilatation. Eight of 19 (42 per cent) in the immediate pushing group and 16 of 22 (73 per cent) in the delayed pushing group had instrumental deliveries (P < 0-05). No difference was found in fetal acid-base balance between the groups either at full cervical dilatation or at delivery and no deterioration in fetal acid-base balance with pushing delayed for a mean of 130min. This data does not support the hypothesis that delayed pushing in the second stage of labour in women with lumbar epidural analgesia reduces the rate of instrumental delivery but does confirm that fetal acid-base balance and condition at birth are not adversely affected.