RT Journal Article
SR Electronic
T1 Fetal Bradycardia and Uterine Hyperactivity Following Subarachnoid Administration of Fentanyl During Labor
JF Regional Anesthesia: The Journal of Neural Blockade in Obstetrics, Surgery, & Pain Control
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 378
OP 381
DO 10.1136/rapm-00115550-199722040-00015
VO 22
IS 4
A1 Friedlander, Jeffrey D.
A1 Fox, Harold E.
A1 Cain, Charles F.
A1 Dominguez, Carmen L.
A1 Smiley, Richard M.
YR 1997
UL http://rapm.bmj.com/content/22/4/378.abstract
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.