An audit of the labour epidural analgesia service at a regional hospital in Gauteng

Abstract

Background Neuraxial analgesia in the form of continuous epidural infusion has been shown to be the most effective analgesic strategy for the labouring mother. In developed countries data are readily available as to the number of women receiving labour epidural analgesia as well as the complication rates of labour epidurals. Data for South Africa on labour epidural analgesia services are limited and there was no published data for Rahima Moosa Mother and Child Hospital (RMMCH).

Methods A retrospective audit using consecutive convenience sampling was done reviewing all epidural records at RMMCH from 1 January to 31 December 2014.

Results During the study period labour epidural analgesia was administered for 187 (1,6%) of 11 853 deliveries. Epidural records were collected for all labour epidurals administered. The most common indications documented were labour analgesia (41,7%) and primigravida (28,9%). Labour epidurals were not administered for specific medical conditions. The incidence of complications was 22,6% and these complications were minor and self-limiting. Hypotension was the most common complication (12,3%). Patient satisfaction with labour epidural analgesia, where documented, was high (98,4%).

Conclusions This audit revealed a low incidence of labour epidural analgesia at RMMCH during the study period. The incidence of complications was in keeping with that seen in developed countries. Poor documentation was noted to be a problem.