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Regional anesthesia · Jul 1997
Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor.
- J D Friedlander, H E Fox, C F Cain, C L Dominguez, and R M Smiley.
- Department of Anesthesiology, College of Physicians & Surgeons of Columbia University, New York, New York 10032, USA.
- Reg Anesth. 1997 Jul 1;22(4):378-81.
Background And ObjectivesChanges 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.MethodsThe patient was given intravenous terbutaline, after which contractions ceased for 20-30 minutes and then resumed.ResultsThe patient underwent successful cesarean delivery. Retrospective analysis of the data revealed a significant increase in uterine tone and contractions following fentanyl administration.ConclusionsThis case supports the view that changes in uterine tone, producing a hyperdynamic contractile state and a resulting decrease in uteroplacental perfusion, may explain the fetal bradycardia following subarachnoid opioid administration. Cases that do not resolve spontaneously may respond to intravenous terbutaline.
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