PT  - JOURNAL ARTICLE
AU  - Friedlander, Jeffrey D.
AU  - Fox, Harold E.
AU  - Cain, Charles F.
AU  - Dominguez, Carmen L.
AU  - Smiley, Richard M.
TI  - Fetal Bradycardia and Uterine Hyperactivity Following Subarachnoid Administration of Fentanyl During Labor
AID  - 10.1136/rapm-00115550-199722040-00015
DP  - 1997 Jul 01
TA  - Regional Anesthesia: The Journal of Neural Blockade in Obstetrics, Surgery, & Pain Control
PG  - 378--381
VI  - 22
IP  - 4
4099  - http://rapm.bmj.com/content/22/4/378.short
4100  - http://rapm.bmj.com/content/22/4/378.full
SO  - Reg Anesth Pain Med1997 Jul 01; 22
AB  - Background and Objectives Changes in uterine tone have been postulated as the cause of fetal bradycardia following subarachnoid administration of fentanyl for labor analgesia. Such a case occurred in a 20-year-old parturient with an intrauterine pressure catheter in place.Methods The patient was given intravenous terbutaline, after which contractions ceased for 20-30 minutes and then resumed.Results The patient underwent successful cesarean delivery. Retrospective analysis of the data revealed a significant increase in uterine tone and contractions following fentanyl administration.Conclusions This case supports the view that changes in uterine tone, producing a hyperdynamic contractile state and a resulting decrease in utero-placental perfusion, may explain the fetal bradycardia following subarachnoid opioid administration. Cases that do not resolve spontaneously may respond to intra-venous terbutaline.