Combined spinal epidural analgesia for labor using sufentanil epidurally versus intrathecally: a retrospective study on the influence on fetal heart trace
-
Nele Everaert
,
Peter Vlerick
Abstract
Objective: We retrospectively compared a protocol using sufentanil and ropivacaine intrathecally with a protocol in which only ropivacaine was administered intrathecally and sufentanil was used epidurally to evaluate whether banning sufentanil from the intrathecal space results in a decreased incidence of adverse fetal heart rate changes.
Methods: Some 520 cardiotocographic tracings were examined for changes in fetal heart rate and uterine activity following two different protocols of combined spinal epidural analgesia. Charts were consulted for neonatal and labor outcome.
Results: When sufentanil was used epidurally instead of intrathecally, the incidence of adverse changes in fetal heart trace was less, demonstrated by a higher percentage of normal reassuring tracings (74.5% vs. 60.4% when sufentanil was used intrathecally; P=0.007), less tracings showing bradycardia (7.5% vs. 14.1%; P=0.035), and more tracings displaying 3 or more accelerations in fetal heart rate in 45 min (93.5% vs. 83.9%; P=0.003) together with less episodes of tachycardia (3.5% vs. 11.4%; P=0.005). There were no differences in labor and neonatal outcome.
Conclusions: Based on fetal heart tracing, it seems favorable to ban sufentanil from the intrathecal compartment.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2015 by De Gruyter
Artikel in diesem Heft
- Frontmatter
- Editorial
- Erich Saling – The Father of Prenatal and Perinatal Medicine—Dedication to his 90th birthday
- Original articles - Obstetrics
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- Original articles - Fetus
- The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol
- Cardiotocography patterns and risk of intrapartum fetal acidemia
- Combined spinal epidural analgesia for labor using sufentanil epidurally versus intrathecally: a retrospective study on the influence on fetal heart trace
- Original articles - Newborn
- Predicting fetal growth deviation in parous women: combining the birth weight of the previous pregnancy and third trimester ultrasound scan
- Letter to the Editor
- A cerclage is not a modified total cervical occlusion!
- Letter Reply
- Reply to: a cerclage is not a modified Total Cervical Occlusion!
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- Erich Saling – The Father of Prenatal and Perinatal Medicine—Dedication to his 90th birthday
- Original articles - Obstetrics
- A transcervical amniotic fluid collector: a new medical device for the assessment of amniotic fluid in patients with ruptured membranes
- Advanced cervical dilatation and spontaneous preterm labor: a comparison between twin and singleton gestations
- Comparison of a novel test for placental alpha microglobulin-1 with fetal fibronectin and cervical length measurement for the prediction of imminent spontaneous preterm delivery in patients with threatened preterm labor
- Does recent sexual intercourse during pregnancy affect the results of the fetal fibronectin rapid test? A comparative prospective study
- Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes
- Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests
- Single versus combination tocolytic regimen in the prevention of preterm births in women: a prospective cohort study
- Recommendations of activity restriction in high-risk pregnancy scenarios: a Danish national survey
- Is pharmacologic research on pregnant women with psychoses ethically permissible?
- Women’s knowledge and attitude towards pregnancy in a high-income developing country
- Impact of maternal body mass index on the cesarean delivery rate in Germany from 1990 to 2012
- Justified skepticism about Apgar scoring in out-of-hospital birth settings
- The effect of the use of oxytocin on blood loss during different postpartum periods
- Original articles - Fetus
- The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol
- Cardiotocography patterns and risk of intrapartum fetal acidemia
- Combined spinal epidural analgesia for labor using sufentanil epidurally versus intrathecally: a retrospective study on the influence on fetal heart trace
- Original articles - Newborn
- Predicting fetal growth deviation in parous women: combining the birth weight of the previous pregnancy and third trimester ultrasound scan
- Letter to the Editor
- A cerclage is not a modified total cervical occlusion!
- Letter Reply
- Reply to: a cerclage is not a modified Total Cervical Occlusion!
- Congress Calendar
- Congress Calendar
