Comparative assessment of newborn condition via APGAR scores in relation to labour pain management: nitrous oxide vs. epidural anaesthesia
Background. The term ‘trial of labour after caesarean’ (TOLAC) is a medical strategy in which a woman who has had a caesarean section in the past tries to deliver her baby vaginally during a future pregnancy as opposed to having another caesarean section. During childbirth, pain relief is important, so epidural anaesthesia and nitrous oxide are often used. Aim. To determine if the evaluation of a newborn using APGAR scores is associated with the method of analgesia during the Trial of Labour After Caesarean (TOLAC). Methods. A retrospective study was conducted at the Obstetrics and Gynaecology Clinic of Kaunas Clinics. Patients who had a successful trial of labour after a caesarean (TOLAC) section from September 1, 2020, to September 1, 2022, were selected from the clinic’s registry. Women were divided into two groups based on the anaesthesia used for managing labour pain: Group I consisted of 147 women who received epidural anaesthesia, while Group II comprised 38 women who were administered nitrous oxide. The newborn’s condition according to the Apgar score was compared between two groups. Data was analysed using IBM Statistics SPSS for frequencies, T and χ2 tests. Results with values of p < 0.05 are considered statistically significant. Results. There were no statistically significant differences observed in the assessment of newborns’ APGAR scores at 1 and 5 minutes after birth between infants born to mothers who received epidural analgesia for labour pain relief and those born to mothers who did not receive this analgesia (χ2 test = 3.228, p = 0.665) (χ2 test = 3.794, p = 0.285). At 1 and 5 minutes after birth, when evaluating the APGAR scores of newborns whose mothers received nitric oxide for pain relief during labour versus those whose mothers did not receive this analgesia, no statistically significant differences were determined (χ2 test = 3.794, p = 0.285) (χ2 tests = 1.609, p = 0.657). At 1 and 5 minutes after birth, when assessing the APGAR scores of newborns whose mothers received epidural analgesia for pain relief during labour compared to those whose mothers received nitric oxide for pain relief, no statistically significant differences were observed (χ2 test = 2.652, p = 0.618) (χ2 test = 1.243, p = 0.537). Conclusion. The condition of the newborn after a successful trial of labour after caesarean (TOLAC) is not affected by the administration of either epidural or nitric oxide analgesia.