Skip to main content

Labour analgesia and fetal bradycardia

Summary

Labour analgesia induction can result in fetal heart rate changes and even severe fetal bradycardia. This is most likely due to uterine hypertonus secondary to an acute drop in circulating epinephrine. If the uterus is quickly relaxed and fetus properly resuscitated, this should not affect the outcome of the delivery or neonatal health.

References

  1. Clarke VT, Smiley RM, Finster M. Uterine hyperactivity after intrathecal injection of fentanyl for analgesia during labour: a cause of fetal bradycardia? (Letter). Anesthesiology 1994; 81: 1083.

    PubMed  Article  CAS  Google Scholar 

  2. Palmer CM, Maciulla JE, Cork RC, Nogami WM, Gossler K, Alves D. The incidence of fetal heart rate changes after intrathecal fentanyl labour analgesia. Anesth Analg 1999; 88: 577–81.

    PubMed  Article  CAS  Google Scholar 

  3. Nielsen PE, Erickson JR, Abouleish EI, Perriatt S, Sheppard C. Fetal heart rate changes after intrathecal sufentanil or epidural bupivacaine for labour analgesia: incidence and clinical significance. Anesth Analg 1996; 83: 742–6.

    PubMed  Article  CAS  Google Scholar 

  4. Cascio M, Pygon B, Bernett C, Ramanathan S. Labour analgesia with intrathecal fentanyl decreases maternal stress. Can J Anaesth 1997; 44: 605–9.

    PubMed  CAS  Article  Google Scholar 

  5. Segal S, Csavoy AN, Datta S. The tocolytic effect of catecholamines in the gravid rat uterus. Anesth Analg 1998; 87: 864–9.

    PubMed  Article  CAS  Google Scholar 

  6. Gambling DR, Sharma SK, Ramin SM, et al. A randomized study of combined spinal-epidural analgesia versus intravenous meperidine during labor: impact on cesarean delivery rate. Anesthesiology 1998; 89: 1336–44.

    PubMed  Article  CAS  Google Scholar 

  7. Eberle RL, Norris MC, Eberle AM, Naulty JS, Arkoosh VA. The effect of maternal position on fetal heart rate during epidural or intrathecal labor analgesia. Am J Obstet Gynecol 1998; 179: 150–5.

    PubMed  Article  CAS  Google Scholar 

  8. Albright GA, Forster RM. Does combined spinal-epidural analgesia with subarachnoid sufentanil increase the incidence of emergency cesarean delivery? Reg Anesth 1997; 22: 400–5.

    PubMed  Article  CAS  Google Scholar 

  9. Riley ET, Cohen SE, Chitkara U. Intravenous nitroglycerin: a potent uterine relaxant for emergency obstetric procedures. Review of literature and report of 3 cases. Int J Obstet Anaesth 1996; 5: 264–8.

    Article  CAS  Google Scholar 

  10. Hawkins JL, Arens JF, Bucklin BA, et al. Practice Guidelines for Obstetrical Anesthesia: a report by the American Society of Anesthesiologists Task Force on Obstetrical Anesthesia. Anesthesiology 1999; 90: 600–11.

    Article  Google Scholar 

  11. Mercier FJ, Donnas M, Bouaziz H, Lhuissier C, Benhamou D. Intravenous nitroglycerin to relieve intrapartum fetal distress related to uterine hyperactivity: a prospective observational study. Anesth Analg 1997; 84: 1117–20.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Edward T. Riley.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Riley, E.T. Labour analgesia and fetal bradycardia. Can J Anesth 50, R27 (2003). https://doi.org/10.1007/BF03018152

Download citation

  • DOI: https://doi.org/10.1007/BF03018152

Keywords

  • Cesarean Delivery
  • Terbutaline
  • Uterine Blood Flow
  • Fetal Bradycardia
  • Placental Blood Flow