Maternal pulse pressure at admission is a risk factor for fetal heart rate changes after initial dosing of a labor epidural: a retrospective cohort study

Miller, Nathaniel R.; Cypher, Rebecca L.; Nielsen, Peter E.; Foglia, Lisa M.

doi:10.1016/j.ajog.2013.05.049

Cited by 8 publications

(2 citation statements)

References 19 publications

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“…We defined FHR abnormality as variable deceleration (an abrupt decline in the FHR beginning with the onset of the contraction; the decelerations measured at least 15 beats per minute [bpm], the total duration was 15 s or more and less than 2 min, and they had an onset-to-nadir phase of less than 30 s), late deceleration (a gradual symmetrical decline in the FHR beginning around the contraction peak and returning to baseline after the end of the contraction, with the nadir of the deceleration occurring 30 s or more after the onset of the deceleration), prolonged deceleration (a fall of 15 bpm or more in the baseline FHR lasting for more than 2 min and less than 10 min) and bradycardia (a fall from the baseline to less than 110 bpm) in this study with reference to previous studies. [13][14][15] We then compared the data of women with or without the new occurrence of FHR abnormality within 1 h after CSEA.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Labor risk factors for fetal heart rate abnormality after combined spinal‐epidural analgesia

Yamamoto

Umehara

Yamashita

et al. 2022

Intl J Gynecology & Obste

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Labor analgesia is widely used throughout the world, especially in developed countries; indeed, it is used in 83% of all deliveries in France, 1 50% in Sweden, 2 63% in England, 3 61% in the USA, 4 and its utilization varies among individual hospitals. In contrast, labor analgesia is only used in 6% of deliveries in Japan, although the usage is increasing. 5 Combined spinal-epidural analgesia (CSEA) has become the favored approach to labor analgesia in recent years because of its rapid analgesic effect compared with epidural analgesia. 6 The effects of CSEA in labor on the incidence of oxytocin augmentation and fetal heart rate (FHR) abnormality, duration of labor, incidence of instrumental delivery or cesarean delivery, and fetal outcomes have been well investigated. [6][7][8][9][10] Monitoring of FHR during labor is widely used. Although its interpretation is subjective, FHR abnormalities are the most influential indicator for labor management. CSEA is reportedly associated with an increased incidence of FHR abnormality. 11 An improvement in pain scores and increased level of sympathetic block have been reported to be associated with FHR abnormality after CSEA, 12,13

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Section: Study Design and Participantsmentioning

confidence: 99%

Labor risk factors for fetal heart rate abnormality after combined spinal‐epidural analgesia

Yamamoto

Umehara

Yamashita

et al. 2022

Intl J Gynecology & Obste

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“…24 In pregnancy, pulse pressure has also been used as an indicator of volume status as evidenced by more frequent post-epidural hypotension in women who present with a narrow pulse pressure (defined as <45 mmHg in a normotensive cohort) prior to epidural placement. [25][26] It may also provide insight into hemodynamics, with a narrow pulse pressure indicating a high SVR state (which may be more responsive to nifedipine or hydralazine) and a wide pulse pressure indicating a high CO state (which may be more responsive to beta blockers), allowing providers to tailor antihypertensive therapy. The use of pulse pressure as a rapid indicator of maternal hemodynamics to guide antihypertensive choice could result in a shorter time to resolution and improve outcomes related to acute-onset, severe hypertension.…”

Section: Introductionmentioning

confidence: 99%

Pulse pressure as a predictor of response to treatment for severe hypertension in pregnancy

Mullan

Vricella

Edwards

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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Fetal Monitoring During Neuraxial Labor Analgesia

Bonnet

Korb

Mignon

2015

Epidural Labor Analgesia

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Maternal pulse pressure at admission is a risk factor for fetal heart rate changes after initial dosing of a labor epidural: a retrospective cohort study

Cited by 8 publications

References 19 publications

Labor risk factors for fetal heart rate abnormality after combined spinal‐epidural analgesia

Labor risk factors for fetal heart rate abnormality after combined spinal‐epidural analgesia

Pulse pressure as a predictor of response to treatment for severe hypertension in pregnancy

Fetal Monitoring During Neuraxial Labor Analgesia

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