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 utero-placental perfusion, may explain the fetal bradycardia following subarachnoid opioid administration. Cases that do not resolve spontaneously may respond to intra-venous terbutaline.
- fetal bradycardia
- subarachnoid labor analgesia
- uterine tone
- intrauterine pressure catheter
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