Maternal factors implicated in fetal bradycardia after combined spinal epidural for labour pain

Nicolet, J; Miller, A; Kaufman, I; Guertin, M C; Deschamps, A (2008). Maternal factors implicated in fetal bradycardia after combined spinal epidural for labour pain. European journal of anaesthesiology, 25(9), pp. 721-5. Philadelphia, Pa.: Lippincott Williams & Wilkins 10.1017/S0265021508004183

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BACKGROUND AND OBJECTIVE: Combined spinal epidural analgesia is effective for fast relief of severe labour pain but has been associated with worrisome decreases in fetal heart rate. Since the reasons for this phenomenon remain elusive, some anaesthesiologists may abstain from using this technique. We postulated that factors unrelated to the neuraxial technique could play a role in the decrease in fetal heart rate. To our knowledge, no prospective study has previously looked into this possibility. METHODS: We collected prospective data on 223 consecutive patients who received combined spinal epidural analgesia (123) or epidural analgesia (100). Maternal blood pressure, analogue pain scores, exogenous infusion of oxytocin, cervical dilatation, maternal age, parity and ethnicity were collected and correlated with the occurrence of decreases in fetal heart rate post combined spinal epidural. RESULTS: Univariate analysis showed a correlation between the incidence of fetal bradycardia and higher maternal pain scores, older maternal age, and combined spinal epidural analgesia. Multivariate analysis revealed that only pain scores and maternal age were independent predictors of fetal bradycardia post neuraxial blockade. CONCLUSIONS: Maternal pain scores and older maternal age are factors unrelated to the neuraxial technique that are independent predictors of fetal bradycardia after neuraxial analgesia for labour.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
UniBE Contributor:	Nicolet, Jacqueline
ISSN:	0265-0215
ISBN:	18400139
Publisher:	Lippincott Williams & Wilkins
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	04 Oct 2013 15:03
Last Modified:	05 Dec 2022 14:19
Publisher DOI:	10.1017/S0265021508004183
PubMed ID:	18400139
Web of Science ID:	000258883600004
URI:	https://boris.unibe.ch/id/eprint/27225 (FactScience: 105080)