Effect of intrapartum pethidine on the neonatal outcome: is it duration related?
Objectives: To study the effect of pethidine on the intrapartum fetal heart rate (FHR) pattern and to assess the neonatal outcome with regards to the interval between pethidine administration to delivery of the fetus. Materials: 73 healthy women intrapartum from labour suite hospital Tengku A...
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Main Authors: | , , , , |
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Format: | Article |
Language: | English English |
Published: |
Elsevier BV
2012
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Online Access: | http://irep.iium.edu.my/32312/1/FIGO.pdf http://irep.iium.edu.my/32312/4/ScienceDirect_-_Search_Results__AUTHORS%28D_Abdulwahab%29.htm http://irep.iium.edu.my/32312/ |
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Summary: | Objectives: To study the effect of pethidine on the intrapartum
fetal heart rate (FHR) pattern and to assess the neonatal outcome
with regards to the interval between pethidine administration to
delivery of the fetus.
Materials: 73 healthy women intrapartum from labour suite
hospital Tengku Ampuan Afzan, Kuantan, Malaysia.
Methods: This is a prospective observational study done on 73
healthy consented women with singleton pregnancy at term. All
fetus were normal, vertex presentation with reactive FHR tracing
before pethidine administration. FHR recording were performed
for 40 minutes prior to and one hour post pethidine. Cervical
dilatation of all patients ≤4cm at time of pethidine administration.
Intramuscular pethidine 1 mg/kg was given as an intrapartum
analgesia. The study sample was divided into two groups, first
group delivered within 4 hours and second group delivered more
than 4 hours after the pethidine administration. The data were
analysed by SSPS 17.0.
Results: the mean age of the recruited patients is 28.15±6.15 years
and mean gestational age of 39.14±1.094 weeks. The mean duration
from pethidine administration to delivery is 296.48±173.65 minutes
(4 hours and 56 minutes). Four (5.5%) cases had suspicious CTG
1 hour post pethidine, 1 with absence of acceleration for 45 minutes
and 3 cases with early deceleration lasted for 60 to 90 minutes. Out
of 73 patients, 38 babies delivered within 4 hours and 35 delivered
after 4 hours of pethidine. All neonates delivered with good Apgar
Score (AS), 8 at 1 minute and 9 at 5 minute except 1 with AS of 5
at 1 min and 7 at 5 min which delivered more than 4 hours after
pethidine. Sixteen (21.9%) cases were admitted to the Neonatal
Intensive Care Unit (NICU). Eleven (68.75%) cases were admitted
due to neonatal sedation from the delivery group less than 4 hours
after pethidine. Five (31.25%) cases from the delivery group more
than 4 hours, 4 cases with a diagnosis of transient tachypnea of
newborn and 1 secondary to meconium aspiration syndrome (MAS).
All discharge to mother after 24 hours, non required ventilation
apart from the one with MAS which required ventilation for one day
and longer admission. Despite of the higher number of those require
admission in the less than 4 hours group, it was not statistically
significant with P value of 7.44.
Conclusions: Pethidine can be used as an intrapartum analgesia
which is safe, easily available without major effect on fetal heart
rate pattern and neonatal outcome even if given in advance stage
of labour. |
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