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Fetal bradycardia due to intrathecal opioids for labour analgesia: a systematic review

  1. Chahé Mardirosoff1,*,
  2. Lionel Dumont2,
  3. Michel Boulvain3,
  4. Martin R. Tramèr2

Article first published online: 22 DEC 2003

DOI: 10.1111/j.1471-0528.2002.01380.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 109, Issue 3, pages 274–281, March 2002

Additional Information

How to Cite

Mardirosoff, C., Dumont, L., Boulvain, M. and Tramèr, M. R. (2002), Fetal bradycardia due to intrathecal opioids for labour analgesia: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 109: 274–281. doi: 10.1111/j.1471-0528.2002.01380.x

Author Information

  1. 1

    Department of Anaesthesiology, Polyclinique de Savoie, Annemasse, France

  2. 2

    Division of Anaesthesiology, Geneva University Hospitals, Geneva, Switzerland

  3. 3

    Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland

**Dr C. Mardirosoff, Département d'Anesthésie-Réanimation, Polyclinique de Savoie, 8 Rue Fernand-David, 74100 Annemasse Cedex, France.

Publication History

  1. Issue published online: 22 DEC 2003
  2. Article first published online: 22 DEC 2003
  3. Accepted 24 October 2001

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Objective To evaluate fetal and maternal adverse effects of intrathecal opioid analgesia during labour.

Data sources A systematic search was performed, in Medline, Embase, the Cochrane Library, bibliographies, and personal contact with authors, in any language, up to February 2001.

Study selection Full reports on randomised comparisons of any analgesia with intrathecal opioid (experimental group) with any non-intrathecal opioid regimen (control group) during labour.

Data extraction Dichotomous data from 24 trials (3513 women).

Results With intrathecal opioids, there was a significant increase in the risk of fetal bradycardia: odds ratio 1.8 (95% confidence interval 1.0 to 3.1), number-needed-to-harm 28. The risk of caesarean section due to fetal heart rate abnormalities was similar (6.0%versus 7.8%). The incidence of pruritus was significantly higher with intrathecal opioids: relative risk 29.6 (95% CI 13.6 to 64.6), number-needed-to-harm 1.7.

Conclusions Intrathecal opioids for labour increase the risk of fetal bradycardia and maternal pruritus. The risk of subsequent caesarean section is not increased.

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