Fetal Bradycardia After Paracervical Block

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Abstract
Three aspects of PCB were studied: a) technic, b) functional signs of nerve block and the earliest signs of toxicity, c) measurements of the anesthetic agent in maternal and fetal blood. Inadvertent infiltration of the myometrium was a frequent cause of transient fetal bradycardia, which was associated with decreased uterine contractility, an action similar to that of adrenalin. Functionally, the decrease in uterine contractility, with or without initial hypertonicity, was associated with a transient decrease in placental blood volume, a slight change in fetal blood pH and transient deceleration of fetal heart rate (FHR). The earliest sign of potential fetal toxicity to PCB is the change in uterine contractility with or without FHR alteration. Measurements of the anesthetic agent are impractical for clinical purposes. Simple monitoring of contractility and FHR, however, may serve as important indicators of drug action on the myometrium and may prevent serious toxicity to the fetus during subsequent blocks.

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