Epidural Analgesia in Labour: IV. Influence on Uterine Activity and Fetal Heart Rate

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Abstract
The influence of epidural block with bupivacaine (Marcaine-adrenaline) on fetal heart rate, uterine activity and the frequency and intensity of contractions was studied in 25 nulliparae [women] at term. Uterine activity decreased during the first 30 min following epidural block. In the time interval 30-40 min after epidural block uterine activity increased again and attained the same level as during the last 10 min before analgesia. The frequency of uterine contractions did not decrease after the block. The lower levels of uterine contractility were due only to a lower amplitude of the contractions. The regularizing effect of epidural analgesia on incoordinate uterine action was noted. The recording of fetal heart rate in the time interval studied revealed no pathological findings. Mode of delivery, mean labor duration and Apgar scores after epidural block were comparable with earlier studies of a larger patient population. Epidural analgesia probably does not induce any important changes in fetal heart rate but temporarily decreases uterine activity.

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