Epidural analgesia and instrumental delivery.

In patients given epidural analgesia who had singleton vertex vaginal deliveries the normal delivery rate was 57%, compared to 80% in all this group. The increase in instrumental delivery rate could partly be accounted for by parity (primigravidae are over-represented in the epidural group), by obstetric and medical indications for epidurals, and by the need for sitting top-ups to relieve perineal pain. There remained a small population of patients in whom epidurals may have contributed to the need for instrumental delivery.