Tags

Type your tag names separated by a space and hit enter

Single injection of terbutaline in term labor. I. Effect on fetal pH in cases with prolonged bradycardia.
Am J Obstet Gynecol 1985; 153(8):859-65AJ

Abstract

Thirty-three patients with prolonged fetal bradycardia (fetal heart rate baseline less than 100 bpm for a minimum of 3 minutes or less than 80 bpm for at least 2 minutes) in labor were studied. They were treated with a bolus injection of terbutaline if the bradycardia persisted at less than 80 bpm for 2 minutes and other efforts to improve the fetal heart rate (oxygen, positional changes) had failed. After the bolus injection a scalp blood pH (or a cord arterial pH in abdominal deliveries) was obtained within 30 minutes. Fetal acidosis was common if the bradycardia lasted 10 minutes or more, particularly if the rate was less than 80 bpm with a flat baseline for 4 minutes or more. The fetal heart rate improved after injection in 30 cases; 23 patients had vaginal delivery of infants in good condition. Ten underwent cesarean section: three for no improvement in fetal heart rate, two for cord prolapse, four for later ominous fetal heart rate, and one for failure to progress. These results suggest that tocolysis in selected cases can be of benefit for the fetus with prolonged bradycardia. In cases with an ominous fetal heart rate pattern preceding the bradycardia and in abruptio placentae immediate operative intervention without delay is probably better. Administration of terbutaline should be regarded as a temporary measure until it is apparent that the fetal heart rate has recovered. Preparation for emergency delivery should be made while a recovery is awaited.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

4073156

Citation

Ingemarsson, I, et al. "Single Injection of Terbutaline in Term Labor. I. Effect On Fetal pH in Cases With Prolonged Bradycardia." American Journal of Obstetrics and Gynecology, vol. 153, no. 8, 1985, pp. 859-65.
Ingemarsson I, Arulkumaran S, Ratnam SS. Single injection of terbutaline in term labor. I. Effect on fetal pH in cases with prolonged bradycardia. Am J Obstet Gynecol. 1985;153(8):859-65.
Ingemarsson, I., Arulkumaran, S., & Ratnam, S. S. (1985). Single injection of terbutaline in term labor. I. Effect on fetal pH in cases with prolonged bradycardia. American Journal of Obstetrics and Gynecology, 153(8), pp. 859-65.
Ingemarsson I, Arulkumaran S, Ratnam SS. Single Injection of Terbutaline in Term Labor. I. Effect On Fetal pH in Cases With Prolonged Bradycardia. Am J Obstet Gynecol. 1985 Dec 15;153(8):859-65. PubMed PMID: 4073156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single injection of terbutaline in term labor. I. Effect on fetal pH in cases with prolonged bradycardia. AU - Ingemarsson,I, AU - Arulkumaran,S, AU - Ratnam,S S, PY - 1985/12/15/pubmed PY - 1985/12/15/medline PY - 1985/12/15/entrez SP - 859 EP - 65 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 153 IS - 8 N2 - Thirty-three patients with prolonged fetal bradycardia (fetal heart rate baseline less than 100 bpm for a minimum of 3 minutes or less than 80 bpm for at least 2 minutes) in labor were studied. They were treated with a bolus injection of terbutaline if the bradycardia persisted at less than 80 bpm for 2 minutes and other efforts to improve the fetal heart rate (oxygen, positional changes) had failed. After the bolus injection a scalp blood pH (or a cord arterial pH in abdominal deliveries) was obtained within 30 minutes. Fetal acidosis was common if the bradycardia lasted 10 minutes or more, particularly if the rate was less than 80 bpm with a flat baseline for 4 minutes or more. The fetal heart rate improved after injection in 30 cases; 23 patients had vaginal delivery of infants in good condition. Ten underwent cesarean section: three for no improvement in fetal heart rate, two for cord prolapse, four for later ominous fetal heart rate, and one for failure to progress. These results suggest that tocolysis in selected cases can be of benefit for the fetus with prolonged bradycardia. In cases with an ominous fetal heart rate pattern preceding the bradycardia and in abruptio placentae immediate operative intervention without delay is probably better. Administration of terbutaline should be regarded as a temporary measure until it is apparent that the fetal heart rate has recovered. Preparation for emergency delivery should be made while a recovery is awaited. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/4073156/Single_injection_of_terbutaline_in_term_labor__I__Effect_on_fetal_pH_in_cases_with_prolonged_bradycardia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9378(85)90690-8 DB - PRIME DP - Unbound Medicine ER -