A Case of Sudden Fetal Bradycardia after Labor Epidural Analgesia

Abstract

A 39-year-old female was admitted at 39 weeks gestation to have a scheduled epidural delivery. An epidural catheter was placed at the L2-3 level. To induce labor, we inserted a balloon catheter into the cervix. After that, labor progressed rapidly and unexpectedly. When the cervix was fully dilated 55 minutes after mechanical dilation, 10 mL of 1％ lidocaine was injected through the epidural catheter. Labor pain score decreased rapidly from 9 to 0. Three minutes after the epidural injection, artificial membrane rupture was performed and FHR suddenly decreased from 160 to 70 bpm. The patient completely lost sensation of uterus contraction and spontaneous pushing was impossible. As fetal bradycardia still persisted, vacuum extraction was performed quickly.

Multiple factors can cause fetal bradycardia especially in the second stage of labor. It is important to evaluate the progress of labor, carefully monitor CTG and labor pain scale, and consider the timing of each procedure. Both obstetricians and anesthesiologists need to collaborate to ensure safe delivery.