Fetal Electrocardiographic Changes Following Lumbar Epidural Analgesia in Labor

Ramasubramanian, R.; Murray, Henry; Danneels, Lieven; Kirk, Donald W.; Symonds, E. M.; Luxton, M. C.; Downing, J W

doi:10.1213/00000539-198702001-00145

Cited by 8 publications

(2 citation statements)

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“…Determining fetal exposure to drugs administered to the mother is important in understanding potential fetal effects. Administration of epidural anesthetics during labor has been associated with changes in fetal heart rate [1], ECG [2], blood gases [3], incidence of bradycardia [4], and with neonatal hypotonia [5]. Other studies have reported associations between epidural bupivacaine and altered neonatal neurobehavioral function [6].…”

Section: Introductionmentioning

confidence: 99%

Newborn Tissue Concentrations of Bupivacaine following Maternal Epidural Administration during Labor in Guinea Pigs

Golub

Kaaekuahiwi

Eisele³

et al. 1998

Neonatology

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Newborn plasma concentrations of maternally administered bupivacaine are often measured, but it is unclear how well they reflect tissue concentrations. Bupivacaine (0.25%) was administered epidurally (0.12 ml/kg) 10 min prior to labor induction in 6 term-pregnant guinea pigs. Plasma, brain, heart and liver samples were obtained for bupivacaine analysis from newborns (n = 22) after spontaneous delivery. Liver bupivacaine concentrations were 2–3 times greater than those in the plasma, brain, and heart. A similar pattern of tissue concentrations was seen in a smaller number of newborns delivered by cesarean section. Liver bupivacaine concentration decreased with drug-delivery interval in littermates, while heart and brain concentrations showed no relationship with drug-delivery interval. Blood gases of newborns reflected acidosis, which may have influenced tissue drug concentrations. Under conditions of the study, bupivacaine concentrations in heart and brain, potential sites of bupivacaine action, were lower than those observed in a peripheral blood sample.

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Section: Introductionmentioning

confidence: 99%

Newborn Tissue Concentrations of Bupivacaine following Maternal Epidural Administration during Labor in Guinea Pigs

Golub

Kaaekuahiwi

Eisele³

et al. 1998

Neonatology

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“…In a previous study, epidural bupivacaine was found to have a positive effect on the PR-FHR correlation coefficient indicating a possible effect of bupivacaine on the fetal myocardial conducting system (7). Our study was designed to further evaluate the effect of epidural bupivacaine on the FECG waveform utilizing the unique properties of the STAN system.…”

Section: Discussionmentioning

confidence: 98%

The Effect of Epidural Bupivacaine on the Fetal Electrocardiogram

Phillips

Umstad

Donnelly

et al. 1996

Aust NZ J Obst Gynaeco

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Fetal electrocardiogram waveform analysis was used to assess the effect of epidural bupivacaine on the fetal myocardial conducting system by evaluating its effect on the PR interval, RR interval, T/QRS ratio and the PR-RR correlation coefficient. There were no significant changes in either the PR interval or the PR-RR correlation coefficient. There was a significant increase in the fetal heart rate and a significant fall in the T/QRS ratio. Epidural bupivacaine does not alter fetal myocardial conduction as measured by the PR interval and it does not induce ischaemic cardiac changes as assessed by the T/QRS ratio.

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Labor analgesia and infant brain development

Golub

1996

Pharmacology Biochemistry and Behavior

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Fetal Electrocardiographic Changes Following Lumbar Epidural Analgesia in Labor

Cited by 8 publications

References 0 publications

Newborn Tissue Concentrations of Bupivacaine following Maternal Epidural Administration during Labor in Guinea Pigs

Newborn Tissue Concentrations of Bupivacaine following Maternal Epidural Administration during Labor in Guinea Pigs

The Effect of Epidural Bupivacaine on the Fetal Electrocardiogram

Labor analgesia and infant brain development

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