Labor risk factors for fetal heart rate abnormality after combined spinal‐epidural analgesia. Issue 3 (5th September 2022)

• Record Type: Journal Article
• Authors: Yamamoto, Yoshiko; Umehara, Nagayoshi; Yamashita, Yoko; Sato, Masaki; Takehara, Kenji; Sago, Haruhiko
• Is Part Of: International journal of gynaecology and obstetrics. Volume 160:Issue 3(2023)
• Page Start: 892
• Page End: 899
• Publication Date: 2022-09-05
• Subjects: combined spinal‐epidural analgesia -- fetal heart rate abnormality -- labor analgesia; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14421
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To explore the association between obstetric factors or outcomes and fetal heart rate (FHR) abnormalities after combined spinal‐epidural analgesia (CSEA). Methods: Women with singleton term deliveries who received CSEA at our institution between January 1 and December 31, 2017, were analyzed using medical records. We performed a logistic regression analysis to compare factors and outcomes between cases with and without new FHR abnormalities within 1 h after CSEA. Results: Of the 393 women, 163 showed the new occurrence of FHR abnormality after CSEA. Rupture of the membrane (odds ratio [OR] 2.49; 95% confidence interval [CI] 1.52–4.09; P < 0.01) and dilatation of the cervix (OR 1.24; 95% CI 1.07–1.44; P < 0.01) were significantly associated with FHR abnormalities. There were significant differences in FHR abnormality rates between women with cervical dilatation of 2 cm or less and 3 cm or more (OR 2.20; 95% CI 1.01–4.81; P = 0.047) and 6 cm or less and 7 cm or more (OR 2.46; 95% CI 1.01–6.01; P = 0.048). FHR abnormalities were not significantly associated with cesarean delivery during labor, instrumental delivery, APGAR score below 7 at 1 or 5 min, or umbilical arterial blood gas pH less than 7.2. Conclusion: Rupture of the membrane and an advanced dilated cervix were risk factors for FHR abnormality when CSEA was initiated. Synopsis: Rupture of the membrane and extended dilated cervix are associated with fetal heart rate abnormality after the introduction of combined spinal‐epidural labor analgesia.