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

J. D. Friedlander, H. E. Fox, C. F. Cain, C. L. Dominguez, R. 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 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 utero- placental perfusion, may explain the fetal bradycardia following subarachnoid opioid administration. Cases that do not resolve spontaneously may respond to intravenous terbutaline.

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

Fingerprint

Terbutaline
Fentanyl
Bradycardia
Uterine Contraction
Analgesia
Opioid Analgesics
Catheters
Perfusion
Parturition
Pressure

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: Case report. Regional Anesthesia, 22(4), 378-381.

Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor : Case report. / Friedlander, J. D.; Fox, H. E.; Cain, C. F.; Dominguez, C. L.; Smiley, R. M.

In: Regional Anesthesia, Vol. 22, No. 4, 1997, p. 378-381.

Research output: Contribution to journalArticle

Friedlander, JD, Fox, HE, Cain, CF, Dominguez, CL & Smiley, RM 1997, 'Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor: Case report', Regional Anesthesia, vol. 22, no. 4, pp. 378-381.
Friedlander, J. D. ; Fox, H. E. ; Cain, C. F. ; Dominguez, C. L. ; Smiley, R. M. / Fetal bradycardia and uterine hyperactivity following subarachnoid administration of fentanyl during labor : Case report. In: Regional Anesthesia. 1997 ; Vol. 22, No. 4. pp. 378-381.
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