title: Placental abruption occurring soon after labor combined spinal-epidural analgesia.
abstract: We present a case of placental abruption necessitating emergency cesarean section in an otherwise uncomplicated patient soon after initiation of combined spinal-epidural analgesia in labor. Administration of spinal opioids has the potential to cause fetal bradycardia due to uterine hypertonicity following rapid onset of analgesia. In this case, a previously bloody show before placement of combined spinal-epidural analgesia may have been evidence of a small abruption. We hypothesize that uterine hypertonicity following administration of spinal opioids may have hastened the development of an existing placental abruption.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University of New Mexico, Albuquerque, NM, USA.
authors.forename: F
authors.initials: F
authors.lastname: Jaime
authors.forename: J
authors.initials: J
authors.lastname: Degani
authors.forename: N
authors.initials: N
authors.lastname: Lam
authors.forename: G
authors.initials: G
authors.lastname: Allen
mesh_terms: D000037:Abruptio Placentae / Q000139:chemically induced*; D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D001919:Bradycardia / Q000139:chemically induced; D002045:Bupivacaine / Q000009:adverse effects; D002585:Cesarean Section / Q000379:methods*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D005500:Follow-Up Studies; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine