Document Detail


Maternal factors implicated in fetal bradycardia after combined spinal epidural for labour pain.
MedLine Citation:
PMID:  18400139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J Nicolet; A Miller; I Kaufman; M C Guertin; A Deschamps
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-04-10
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  25     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-06     Completed Date:  2008-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  721-5     Citation Subset:  IM    
Affiliation:
McGill University Health Centre, Royal Victoria Hospital, Department of Anesthesiology, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
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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