The Effect of Combined Spinal-Epidural Versus Epidural Analgesia in Laboring Women on Nonreassuring Fetal Heart Rate Tracings: Systematic Review and Meta-analysis

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(Anesth Analg. 2016;123(4):955–964)Studies have reported that combined spinal-epidural (CSE) analgesia is associated with a higher incidence of fetal heart rate (FHR) abnormalities. However, recent trials have not corroborated this finding. Consequently, the authors of the present study conducted a systematic review and meta-analysis comparing the incidence of nonreassuring FHR tracings in parturients who received labor analgesia initiated by the CSE versus epidural analgesia technique. In this study, primary outcomes were nonreassuring FHR tracings and fetal bradycardia; the secondary outcome was the incidence of cesarean delivery performed for nonreassuring FHR tracing.

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