Association of epidural block analgesia combined with Low-dose oxytocin with pain intensity and delivery outcomes in primiparous women.

BACKGROUND

Epidural block is an effective labor analgesia method; adjunctive low-dose oxytocin may further influence uterine dynamics and clinical outcomes, but evidence in primiparas is limited.

OBJECTIVE

To evaluate the association of epidural analgesia combined with low-dose oxytocin with pain intensity, labor duration, delivery mode, and immediate maternal-neonatal outcomes in primiparous women.

METHODS

In this retrospective study, 120 eligible primiparous women who delivered between January 2023 and January 2025 were classified by analgesia regimen into a combination group (epidural analgesia plus low-dose oxytocin) or a control group (epidural analgesia alone). We compared maternal demographics, VAS pain scores, durations of each labor stage, delivery mode, postpartum blood loss, maternal adverse events, and short-term neonatal outcomes (Apgar scores, NICU admission).

RESULTS

The combination group showed markedly lower VAS scores at 30 min after analgesia, in active labor, and 2 h postpartum (3.1 ± 0.9 vs. 7.0 ± 1.0; 3.5 ± 1.0 vs. 6.8 ± 1.1; 2.8 ± 0.8 vs. 6.5 ± 1.0; all P < 0.001). First-stage, second-stage and total labor durations were shorter in the combination group (all P < 0.05). Vaginal delivery rate was higher (86.7% vs. 60.0%, P = 0.001) and emergency cesarean lower (10.0% vs. 30.0%, P = 0.006); combined treatment remained associated with vaginal birth (adjusted OR = 1.92, 95% CI = 1.10-3.34, P = 0.02). Common short-term maternal adverse events did not differ significantly between groups(P > 0.05), but hospital stay was shorter with the combination (P = 0.001).

CONCLUSIONS

Epidural analgesia combined with low-dose oxytocin was associated with lower labor pain scores, shorter labor duration, and a higher rate of vaginal delivery in primiparous women, without a detectable increase in common short-term maternal or neonatal adverse events.