Fetal heart rate changes after fetal intravascular treatment with pancuronium bromide

Bruce W. Pielet*, Michael L Socol, Scott N. MacGregor, Sharon L Dooley, John Minogue

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Because of recurrent needle dislodgement secondary to fetal movement, we have altered our intravascular transfusion technique by replacing maternal premedication (meperidine and diazepam [group 1]) with fetal intravascular infusion of pancuronium bromide (Pavulon [group 2]), a nondepolarizing neuromuscular blocking agent. Baseline fetal heart rate, number of accelerations, and variability were assessed before and after transfusion in both groups. Whereas there were no changes after transfusion in the former group, those fetuses who received pancuronium bromide demonstrated a dramatic abolishment of accelerations and decrease in variability, with the heart rate pattern often appearing "sinusoidal-like." These alterations in fetal heart rate were temporary changes that reverted to normal once the fetus "awakened" from the neuromuscular blockade. We speculate that these changes in fetal heart rate are secondary to the interaction of the reported hypertensive and vagolytic effects of pancuronium bromide.

Original languageEnglish (US)
Pages (from-to)640-643
Number of pages4
JournalAmerican journal of obstetrics and gynecology
Volume159
Issue number3
DOIs
StatePublished - Jan 1 1988

Keywords

  • Fetal heart rate
  • intravascular pancuronium bromide

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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