title: [Post-asphyctic encephalopathy of the neonate following administration of nalbuphine during childbirth].
abstract: After an intramuscular injection of nalbuphine during parturition a foetal bradycardia of 30-40 beats/minute developed, which normalised after an intravenous maternal injection of naloxone. Because the cardiotocography did not show variability after the event, a caesarean section was performed. Six months later the child still had a severe neurological disorder which was attributed to intrauterine asphyxia. Several authors published reports in which no relevant clinical problems were described after nalbuphine given during labour. Recently, however, four children have been described with bradycardia and respiratory depression after maternal intravenous and/or intramuscular injection of nalbuphine. Apparently, the use of nalbuphine during labour can cause foetal bradycardia, both after intravenous and after intramuscular administration. Great reserve is advised regarding use of nalbuphine for this indication. The antidote naloxone should be within reach.
authors.affiliation: Rijksinstituut voor Volksgezondheid en Milieuhygiëne, Teratologie Informatie Service, Bilthoven.
authors.forename: B P
authors.initials: BP
authors.lastname: van Nesselrooij
authors.forename: F J
authors.initials: FJ
authors.lastname: Roumen
authors.forename: A J
authors.initials: AJ
authors.lastname: Da Costa
authors.forename: W J
authors.initials: WJ
authors.lastname: Maertzdorf
authors.forename: B H
authors.initials: BH
authors.lastname: Stricker
authors.forename: J M
authors.initials: JM
authors.lastname: Garbis-Berkvens
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000139:chemically induced* / Q000150:complications; D001927:Brain Diseases / Q000209:etiology*; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D009266:Nalbuphine / Q000009:adverse effects*; D011247:Pregnancy
chemical_list: D009266:Nalbuphine
vernacular_title: Postasfyctische encefalopathie van de pasgeborene na toediening van nalbufine tijdens de baring.