EP08.20: Effect of intrapartum epidural analgesia on rate of emergency delivery for presumed fetal compromise in small‐for‐gestational‐age fetuses

To evaluate the association between emergency delivery for presumed fetal compromise and epidural analgesia (EDA) in small for gestational age (SGA) fetuses delivered beyond 36 weeks' gestation. Retrospective single-centre cohort study performed in a referral hospital. Small for gestational age fetuses delivered beyond 36 weeks from 10/2023 to 03/2024 were included. Multiple pregnancies, non-cephalic presentation at delivery and pregnancies complicated by fetal anomalies were excluded. Data about pregnancy, epidural analgesia, labour and delivery were collected from our computerised database to compare the incidence of emergency delivery for presumed fetal compromise according to EDA in small for gestational age fetuses. The Fisher‘s exact test were used for the analysis of contingency tables of proportions in different groups, p value < 0.05 was considered statistically significant. We included in the study 245 pregnancies complicated by SGA fetuses, median gestational age at delivery was 37,8 (Interquartile range (IQR) 37.28-39.0) weeks' gestation and median birthweight was 2,482g (IQR 2256-2662). Planned Caesarean delivery before labour was performed in 85 (35%) cases. Among the remaining 160 patients, 65/160 (41%) received EDA and 95/160 (59%) received no analgesia during labour. Emergency delivery for presumed fetal compromise occurred in 5/65 (7.6%) women with EDA and in 17/95 (17,8%) without epidural analgesia (p = 0.1002). Intrapartum EDA is not associated with a higher risk of emergency delivery for presumed fetal compromise compared with no analgesia in SGA fetuses.