Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor

Jeffrey D. Friedlander, Harold E. Fox, Charles F. Cain, Carmen L. Dominguez, Richard M. Smiley

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Changes 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. Methods. The patient was given intravenous terbutaline, after which contractions ceased for 20-30 minutes and then resumed. Results. The patient underwent successful cesarean delivery. Retrospective analysis of the data revealed a significant increase in uterine tone and contractions following fentanyl administration. Conclusions. This 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 intra-venous terbutaline.

Original languageEnglish (US)
Pages (from-to)378-381
Number of pages4
JournalRegional Anesthesia
Volume22
Issue number4
StatePublished - Dec 1 1997

    Fingerprint

Keywords

  • Fentanyl
  • Fetal bradycardia
  • Intrauterine pressure catheter
  • Subarachnoid labor analgesia
  • Terbutaline
  • Uterine tone

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Friedlander, J. D., Fox, H. E., Cain, C. F., Dominguez, C. L., & Smiley, R. M. (1997). Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor. Regional Anesthesia, 22(4), 378-381.