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SM ISO690:2012 DONDIUC, Iurie, CARDANIUC, Corina. Efectul analgeziei în naştere asupra stării intrauterine a fătului. In: Analele Ştiinţifice ale USMF „N. Testemiţanu”, 2011, nr. 5(12), pp. 41-46. ISSN 1857-1719. |
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Analele Ştiinţifice ale USMF „N. Testemiţanu” | ||||||
Numărul 5(12) / 2011 / ISSN 1857-1719 | ||||||
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Pag. 41-46 | ||||||
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Rezumat | ||||||
The effect of analgesia in labor on the intrauterine state of the fetus
The study was directed to evaluate the effect of epidural analgesia and Promedol
analgesia during labor on intrauterine fetal condition. Analgesic efficiency of methods, the
maternal adverse effects and duration of labor were evaluated. The results showed that epidural
analgesia is more frequently associated with maternal hypotension, increased duration of labor
and more frequent administration of oxytocin to stimulate uterine contractions. Both types of
analgesia: epidural and Promedol induce deterioration of fetal heart rate without significant
effect on newborn condition at birth. Epidural analgesia is associated more frequently with a rise
of fetal heart rate and occurrence of variable decelerations. These changes may be due to
maternal hypotension. The changes are usually transient and do not cause maternal or fetal
morbidity. Systemic analgesia with Promedol is associated more frequently with suspicious and
pathological cardiotocografic patterns and a higher rate of instrumental births. Promedol
administered during childbirth reduces variability of the fetal heart rate and mask the reduced
variability associated with hypoxia. Our results confirm the need for confirmation of a reactive
normal cardiotocografic pattern, without signs of fetal hypoxia before administering any type of
labor analgesia. The existence of serious heart rhythm abnormalities on the fetal CTG represents
a contraindication for administration of analgesia. |
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