Zeitschrift für Geburtshilfe und Perinatologie
-
Z Geburtshilfe Perinatol · Jun 1980
[The clinical significance of accelerations in intrapartum fetal heart rate monitoring (author's transl)].
Fetuses failing to exhibit accelerations in antepartum fetal heart rate (FHR) testing are considered to be at risk. However, until now the prognostic value of intrapartum FHR-accelerations is not known. ⋯ This difference is statistically significant. If accelerations were observed, no correlation was found between rate of FHR increase, amplitude, or duration of accelerations, and fetal or neonatal state.
-
Z Geburtshilfe Perinatol · Oct 1975
Case Reports[Perinatal deaths associated with paracervical anesthesia (author's transl)].
Two infants' death associated with paracervical anesthesia are reported. In both cases a severe fetal bradycardia which developed 5 and 10 minutes, respectively, after paracervical injection of 10 ml of 0.5% Bupivacain, was the reason for Caesarean section. The clinical signs of the infants were similar: low Apgar score, primary apnea, grey colour, flaccidity, no reactions; after a few hours, however, general muscular hypertonus, and repeated attacks of tonic seizures. Accidental injection of Bupivacain into the fetus cannot be excluded in both cases. -- The fetal risks through paracervical anesthesia are being reviewed.
-
In German speaking countries peridural anesthesia in obstetrics has been introduced 25 years ago by Anselmino. Because of the increase of operative delivery and the--however rare--serious complications in the mother the technique has been employed less and less. Now, with the introduction of the catheter technique, which renders lower doses of the anesthetic effective and with improved treatment of complications due to it, the technique has become safer for the mother. ⋯ Further investigations of the effects on fetal heart frequency and its assessment in supine or constant lateral positioning and of the maternal circulation with modern cardiologic techniques have not yet been concluded. On their results will depend, at least in part, the indication for peridural anesthesia in pregnancies and deliveries at risk. Clinical observations and comparison with deliveries under general anesthesia indicate that catheter peridural anesthesia may be advantageous for the child with diabetes, EPH gestosis and prematurity.