South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The mechanism of episodes of fetal bradycardia during epidural analgesia is unknown in the majority of cases. This retrospective study considers the relationship between prolonged fetal bradycardia and epidural analgesia during labour. Of 705 cardiotocographs recorded during administration of epidural analgesia for patients in labour, 207 were suitable for analysis. ⋯ It is concluded that administration of epidural analgesia is significantly associated with episodes of prolonged fetal bradycardia, but that there is usually a return to pre-epidural patterns. The fetal heart rate should be monitored during epidural block administration to confirm the return to baseline rate and normal variability. Episodes of fetal bradycardia that return to a normal pattern do not necessitate early delivery.
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Fractures of the occipital condyle are rare and occur when the head is severely injured; they may be associated with fractures of the skull and the cervical spine. Conservative management appears to give satisfactory results.