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Severe fetal bradycardia in a pregnant surgical patient despite normal oxygenation and blood pressure.

Title: Severe fetal bradycardia in a pregnant surgical patient despite normal oxygenation and blood pressure.
Authors: Ong BY; Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba, Canada. ong@cc.umanitoba.ca; Baron K; Stearns EL; Baron C; Paetkau D; Segstro R
Source: Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 2003 Nov; Vol. 50 (9), pp. 922-5.
Publication Type: Case Reports; Journal Article
Language: English
Journal Info: Publisher: Springer New York Country of Publication: United States NLM ID: 8701709 Publication Model: Print Cited Medium: Print ISSN: 0832-610X (Print) Linking ISSN: 0832610X NLM ISO Abbreviation: Can J Anaesth Subsets: MEDLINE
Imprint Name(s): Publication: New York : Springer New York; Original Publication: [Toronto, Ont.] : Canadian Anaesthetists' Society, [c1987-
MeSH Terms: Blood Pressure/*physiology ; Bradycardia/*etiology ; Cholecystectomy/*adverse effects ; Fetal Distress/*etiology ; Oxygen/*blood; Anesthetics, Inhalation/administration & dosage ; Anesthetics, Intravenous/administration & dosage ; Blood Pressure/drug effects ; Heart Rate/drug effects ; Heart Rate/physiology ; Methyl Ethers/administration & dosage ; Oxygen/administration & dosage ; Piperidines/administration & dosage ; Adult ; Anesthesia, General ; Apgar Score ; Cesarean Section ; Female ; Fetal Monitoring ; Heart Rate, Fetal ; Humans ; Infant, Newborn ; Pregnancy ; Remifentanil ; Severity of Illness Index ; Sevoflurane
Abstract: Purpose: To report and discuss a case of fetal bradycardia in a parturient under anesthesia for cholecystectomy despite normal maternal oxygenation and arterial blood pressure.; Clinical Features: A 27-yr-old woman (gravida 2 para 1), with a fetus of 34 weeks gestation, received general anesthesia for cholecystectomy. After anesthesia induction and tracheal intubation, anesthesia was maintained with oxygen, sevoflurane and iv remifentanil infusion. While preparing for surgery, the fetal heart rate decreased within about half a minute to 70 beats x min(-1) and remained at that level. The maternal blood pressure, heart rate and oxygen saturation were normal. An emergency Cesarean delivery was performed. The infant had Apgar scores of 1 at one minute, 5 at five minutes, 7 at ten minutes and required resuscitation after birth.; Conclusion: Ideally, women having non-obstetric surgery during the third trimester of pregnancy will have intraoperative fetal heart rate monitoring.
Substance Nomenclature: 0 (Anesthetics, Inhalation); 0 (Anesthetics, Intravenous); 0 (Methyl Ethers); 0 (Piperidines); 38LVP0K73A (Sevoflurane); P10582JYYK (Remifentanil); S88TT14065 (Oxygen)
Entry Date(s): Date Created: 20031118 Date Completed: 20040510 Latest Revision: 20181130
Update Code: 20260130
DOI: 10.1007/BF03018740
PMID: 14617590
Database: MEDLINE

Case Reports; Journal Article