Factors for predicting cesarean section during epidural analgesia: a retrospective study

Purpose of investigation: To explore the risk factors for cesarean section during trial of labor with epidural analgesia. Materials and methods: A total of 100 parturients who received epidural analgesia were selected for this study. Fifty parturients underwent vaginal deliveries and 50 parturients underwent cesarean sections. Patient-controlled epidural analgesia (PCEA) was carried out with the continuous infusion of 0.125% bupivacaine and 2 mcg/ml fentanyl at 6 ml/h with patient-controlled analgesia (6 ml/time, locked time 15 minutes). Results: The univariate analysis showed a significant difference in the gestational age of parturients between cesarean section and vaginal delivery (p = 0.013). Compared with the parturients in the vaginal delivery group, cesarean section group parturients showed longer interval time from epidural analgesia to cesarean section (p < 0.001), a higher number of analgesia interventions (p < 0.001), higher doses of PCEA (p < 0.001), and higher number of top-ups (p = 0.015). Multivariate analysis revealed that a high gestational age and long interval time were strongly associated with a high possibility of cesarean section during epidural analgesia. Conclusion: High gestational age and long interval time are important risk factors for the prediction of cesarean section during epidural analgesia.