Fetal heart rate pattern before and after paracervical anesthesia

A prospective study of the fetal heart rate pattern during labor before and after paracervical blockade (PCB) was performed. The material comprised 469 women in labor, or 28% of 1 673 women delivered during a 6-month period. The majority of the anesthesias (87%) were administered by specially trained midwives. Bupivacain (Marcain) was the anestethic used. The injections were made at four different points at a cervical diameter of 3 - 9 cm. The concentration of the anesthetic was 0.25 or 1.25% generally in 10 ml of normal saline. A second PCB was administered in 54 patients at least one hour after the preceding one. Fetal heart rate (FHR) was recorded via a scalp electrode and the pattern studied 15 min before and 30 min after the injection of the anesthetic. Bradycardia was defined as a persistent deceleration exceeding 3 min and occurring within 30 min of the PCB. Variability and acceleration pattern persisted independently of the PCB. Following PCB, decelerations of all types increased, while the basal ...