Fetal heart rate patterns and uterine activity after segmental epidural analgesia. 1977

P Jouppila, and R Jouppila, and K Käär, and M Merilä

The effects of low-dose segmental epidural analgesia on fetal heart rate (FHR) patterns, uterine activity, and some clinical features were examined in a series of 105 normal parturients. The aim of the analgesic technique was to relieve pain during the first stage of labour by blocking the sensory nerve fibres at the spinal level of T 10 to T12, with either 0-5 per cent bupivacaine or bupivacaine with adrenaline 1 : 200 000, the dose varying from 10 to 25 mg. Obvious pathological changes (late decelerations, prolonged fetal bradycardia, variable deceleration, or loss of beat to beat variation) in FHR patterns within the first 30 minutes after the beginning of analgesia were noted in 9 per cent of the patients. Addition of adrenaline to the analgesic agent seemed to reduce uterine activity for 60 minutes after the analgesia and this was reflected in a longer interval between the block and delivery. A 25 per cent fall in systolic blood pressure was recorded in 11 per cent of the patients. Nine patients required vacuum extractions. Our results show that the epidural technique employed has distinct advantages over the previous methods, which require larger doses of the analgesic, agent, and is therefore safer for the fetus; the addition of adrenaline to the analgesic agent is contraindicated.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004837 Epinephrine The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS. Adrenaline,4-(1-Hydroxy-2-(methylamino)ethyl)-1,2-benzenediol,Adrenaline Acid Tartrate,Adrenaline Bitartrate,Adrenaline Hydrochloride,Epifrin,Epinephrine Acetate,Epinephrine Bitartrate,Epinephrine Hydrochloride,Epinephrine Hydrogen Tartrate,Epitrate,Lyophrin,Medihaler-Epi,Acetate, Epinephrine
D005260 Female Females
D005318 Fetal Heart The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (HEART/embryology) only on the basis of time. Fetal Hearts,Heart, Fetal,Hearts, Fetal
D006339 Heart Rate The number of times the HEART VENTRICLES contract per unit of time, usually per minute. Cardiac Rate,Chronotropism, Cardiac,Heart Rate Control,Heartbeat,Pulse Rate,Cardiac Chronotropy,Cardiac Chronotropism,Cardiac Rates,Chronotropy, Cardiac,Control, Heart Rate,Heart Rates,Heartbeats,Pulse Rates,Rate Control, Heart,Rate, Cardiac,Rate, Heart,Rate, Pulse
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000773 Anesthesia, Obstetrical A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth. Anesthesia, Gynecological,Anesthesia, Obstetric,Gynecologic Anesthesia,Paracervical Block,Anesthesia, Gynecologic,Block, Paracervical,Blocks, Paracervical,Gynecological Anesthesia,Obstetric Anesthesia,Obstetrical Anesthesia,Paracervical Blocks
D014590 Uterine Contraction Contraction of the UTERINE MUSCLE. Myometrial Contraction,Contraction, Myometrial,Contraction, Uterine,Contractions, Myometrial,Contractions, Uterine,Myometrial Contractions,Uterine Contractions

Related Publications

P Jouppila, and R Jouppila, and K Käär, and M Merilä
January 1976, Acta obstetricia et gynecologica Scandinavica,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
February 1994, The Australian & New Zealand journal of obstetrics & gynaecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
August 1993, The Australian & New Zealand journal of obstetrics & gynaecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
May 1994, The Australian & New Zealand journal of obstetrics & gynaecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
August 1994, The Australian & New Zealand journal of obstetrics & gynaecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
December 1993, Canadian journal of anaesthesia = Journal canadien d'anesthesie,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
December 2004, Obstetrics and gynecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
June 2005, Obstetrics and gynecology,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
July 1963, Minerva ginecologica,
P Jouppila, and R Jouppila, and K Käär, and M Merilä
January 1964, Minerva medica,
Copied contents to your clipboard!