| Maternal factors implicated in fetal bradycardia after combined spinal epidural for labour pain. | |
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MedLine Citation:
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PMID: 18400139 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Combined spinal epidural analgesia is effective for fast relief of severe labour pain but has been associated with worrisome decreases in fetal heart rate. Since the reasons for this phenomenon remain elusive, some anaesthesiologists may abstain from using this technique. We postulated that factors unrelated to the neuraxial technique could play a role in the decrease in fetal heart rate. To our knowledge, no prospective study has previously looked into this possibility. METHODS: We collected prospective data on 223 consecutive patients who received combined spinal epidural analgesia (123) or epidural analgesia (100). Maternal blood pressure, analogue pain scores, exogenous infusion of oxytocin, cervical dilatation, maternal age, parity and ethnicity were collected and correlated with the occurrence of decreases in fetal heart rate post combined spinal epidural. RESULTS: Univariate analysis showed a correlation between the incidence of fetal bradycardia and higher maternal pain scores, older maternal age, and combined spinal epidural analgesia. Multivariate analysis revealed that only pain scores and maternal age were independent predictors of fetal bradycardia post neuraxial blockade. CONCLUSIONS: Maternal pain scores and older maternal age are factors unrelated to the neuraxial technique that are independent predictors of fetal bradycardia after neuraxial analgesia for labour. |
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Authors:
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J Nicolet; A Miller; I Kaufman; M C Guertin; A Deschamps |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-04-10 |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 25 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-06 Completed Date: 2008-12-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 721-5 Citation Subset: IM |
Affiliation:
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McGill University Health Centre, Royal Victoria Hospital, Department of Anesthesiology, Montreal, Quebec, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Analgesia, Epidural / adverse effects* Anesthesia, Obstetrical / adverse effects* Anesthesia, Spinal / adverse effects* Blood Pressure / drug effects Bradycardia / etiology* Female Heart Rate, Fetal / drug effects Humans Labor Pain / drug therapy, physiopathology* Mothers Pain Measurement Pregnancy Prospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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