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FETAL HEART RATE CHANGES AFTER ACCIDENTAL INTRAUTERINE LIDOCAINE

From the Department of Obstetrics and Gynecology, University of Southern California School of Medicine, and Women's Hospital, Los Angeles County-USC Medical Center, Los Angeles, California

Abstract

Fetal heart rate (FHR) decelerations resembling post-paracervical block (PCB) bradycardia were observed immediately after the inadvertent intrauterine injection of lidocaine hydrochloride. A review of the pathophysiology of post-PCB bradycardia is presented. The administration of a local anesthetic, either into the paracervical tissues or directly into the uterine cavity, may precipitate FHR decelerations principally, through arterial vasoconstriction with subsequent reflex responses and/or hypoxia in the fetus.

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