title: [Analysis of fetal heart rate abnormalities occurring within one hour after laying of epidural analgesia].
abstract: OBJECTIVE
  The objective of this study is to classify abnormalities of fetal heart rate (FHR) occurring in the first hour after performing the epidural analgesia, and to assess the impact of these abnormalities on delivery and on after-birth neonatal state.
  
  
  METHODS
  Retrospective study of 6676 patients continuously from 1 January 2007 to 31 December 2010 who benefited, during the labor, of epidural analgesia. Seven hundred and sixty (14,1%) presented anomalies of FHR in the hour following the laying of epidural (group 1), and 5916 showed no abnormalities of the RCF (group 2).
  
  
  RESULTS
  Among the 760 anomalies of the FHR in the hour following the laying of epidural, 319 (42%) showed prolonged decelerations, 169 (22.2%) variable decelerations, 122 (16.1%) early decelerations, 110 (14.5%) late decelerations and 40 bradycardia (5.3%). In the group 1, incidence of caesarean delivery was 21.4% (163 patients); in group 2, it was 9.63% (P<0.002). In group 1, the umbilical artery pH was less than 7.20 in 13,6% of patients, whereas in group 2, the prevalence was only 6,5% (P<0.002). There is no statistically significant differences on Apgar score between the two groups.
  
  
  CONCLUSIONS
  This study helped to characterize anomalies in the FHR following epidural. There is an increase of obstetric interventions. There is no impact on neonatal clinical state. The administration of systematic ephedrine shall be investigated to reduce these interventions.
authors.affiliation: Service de gynécologie obstétrique, département de périnatalogie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. Electronic address: diane.korb@wanadoo.fr.
authors.forename: D
authors.initials: D
authors.lastname: Korb
authors.forename: M
authors.initials: M
authors.lastname: Bonnin
authors.forename: J
authors.initials: J
authors.lastname: Michel
authors.forename: J-F
authors.initials: JF
authors.lastname: Oury
authors.forename: O
authors.initials: O
authors.lastname: Sibony
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D001034:Apgar Score; D001919:Bradycardia / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007743:Labor, Obstetric; D011247:Pregnancy; D012189:Retrospective Studies; D014469:Umbilical Arteries
keywords: Analgésie péridurale; Anomalies du rythme cardiaque fœtal; Epidural analgesia; Fetal heart rate abnormalities; Intrapartum fetal assessment; Surveillance pendant le travail