An observational study in Labor Pain and to Reduce Pain, sponsored by Başakşehir Çam & Sakura City Hospital. Completed at 2 sites in Turkey (Türkiye). Open to female participants aged 18 Years to 50 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-10.
Sponsored by Başakşehir Çam & Sakura City Hospital · Observational
This retrospective cohort study evaluated whether the timing of epidural analgesia initiation affects labor outcomes in obstetric patients. Patients were categorized as EARLY (cervical dilation less than 4 cm, n=59) or LATE (4 cm or greater, n=129) at epidural placement. The primary outcome was second stage labor duration in vaginally delivering patients (n=177). Secondary outcomes included first stage duration, epidural-to-delivery interval, total fentanyl consumption, cesarean section rate, and neonatal outcomes. EARLY epidural initiation was associated with significantly longer second stage duration (37 vs 25 min, p=0.003), higher fentanyl consumption (56 vs 36 mcg, p\<0.001), and higher cesarean section rate (13.6% vs 2.3%, p=0.005). Neonatal outcomes were comparable between groups.
Epidural analgesia is the most effective method for labor pain management. The optimal timing of initiation has historically been debated, with concerns that early placement may prolong labor or increase operative delivery rates. This single-center retrospective cohort study was conducted at BasaksehirCamSakuraSehirH, Istanbul, following standardization of the institutional epidural protocol (June 2025 - July 2026). A total of 196 patients were screened; 8 were excluded due to inaccessible epidural records, leaving 188 patients for analysis (EARLY n=59, LATE n=129). The epidural solution consisted of bupivacaine 1 mg/mL and fentanyl 1 mcg/mL in 100 mL normal saline. The primary outcome (second stage duration) was analyzed in vaginally delivering patients only (n=177). Multiple linear regression confirmed that early epidural timing was an independent predictor of longer second stage duration (beta=+9.5 min, p=0.034) and higher opioid consumption (beta=+9.6 mcg, p=0.001) after adjusting for nulliparity and epidural duration. Logistic regression demonstrated that early timing was associated with a 6.3-fold increased odds of cesarean delivery (OR 6.28, 95% CI 1.56-25.18, p=0.010). The study was approved by the Acibadem University Non-Interventional Research Ethics Committee (ATADEK 2026/14, September 24, 2026).
423 studies on the registry are indexed under Labor Pain; 74 are open to participants now.
This study's enrollment of 188 is above the median of 132 across 62 observational studies indexed under Labor Pain.
Browse Labor Pain studies →Başakşehir Çam & Sakura City Hospital is the lead sponsor of 109 studies on the registry; 36 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Obstetric patients who requested and received epidural labor analgesia at Acibadem Maslak Hospital between June 1, 2025 and July 1, 2026, following standardization of the hospital epidural protocol.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Patients who received epidural analgesia at cervical dilation less than 4 cm. n=59.
Procedure: Epidural labor analgesia
Patients who received epidural analgesia at cervical dilation 4 cm or greater. n=129.
Procedure: Epidural labor analgesia
Bupivacaine 1 mg/mL + fentanyl 1 mcg/mL in 100 mL normal saline. Timing of initiation (early vs late) constitutes the exposure.
Second Stage Labor Duration
Duration of the second stage of labor from full cervical dilation to delivery, measured in minutes. Analyzed in vaginally delivering patients only (n=177).
Time frame: Perioperative/Periprocedural
First Stage Labor Duration
Duration from epidural placement to full cervical dilation, in minutes.
Time frame: Perioperative/Periprocedural
Epidural-to-Delivery Interval
Time from epidural catheter placement to delivery, in minutes.
Time frame: Perioperative/Periprocedural
Total Opioid Consumption
Cumulative fentanyl dose (micrograms) administered via epidural from placement to delivery.
Time frame: Perioperative/Periprocedural
Cesarean Section Rate
Proportion of patients delivering by cesarean section in each group.
Time frame: Perioperative/Periprocedural
APGAR Score at 1 Minute
Neonatal APGAR score at 1 minute after delivery.
Time frame: Perioperative/Periprocedural
APGAR Score at 5 Minutes
Neonatal APGAR score at 5 minutes after delivery.
Time frame: Perioperative/Periprocedural
Neonatal Birth Weight
Birth weight in grams.
Time frame: Perioperative/Periprocedural
NICU Admission Rate
Proportion of neonates requiring NICU admission.
Time frame: Day 1
Need for Neonatal Resuscitation
Proportion of neonates requiring any resuscitation at birth
Time frame: Perioperative/Periprocedural
Maternal Intrapartum Hypotension
Proportion with systolic BP less than 90 mmHg or greater than 20% decrease from baseline after epidural.
Time frame: Perioperative/Periprocedural
Plan to share: No — Individual patient data will not be shared due to institutional privacy regulations and retrospective design.
No publications or documents are linked to this record.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.
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