FETAL BRADYCARDIA AND UTERINE HYPERACTIVITY FOLLOWING SUBARACHNOID ADMINISTRATION OF FENTANYL DURING LABOR - CASE-REPORT

Background and Objectives. Changes in uterine tone have been postulate d as the cause of fetal bradycardia following subarachnoid administrat ion of fentanyl for labor analgesia. Such a case occurred in a 20-year -old parturient with an intrauterine pressure catheter in place. Metho ds. The patient was given intravenous terbutaline, after which contrac tions 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 contracti le state and a resulting decrease in uteroplacental perfusion, may exp lain the fetal bradycardia following subarachnoid opioid administratio n. Cases that do not resolve spontaneously may respond to intravenous terbutaline.