Abstract
Foetal heart rate and tocodynamic monitoring of the uterus was performed in five pregnant patients undergoing urgent or emergency surgery unrelated to their pregnancy. All received general anaesthesia with halothane or enflurane and nitrous oxide. The loss of beat-to-beat variation of the foetal heart rate was observed in all patients under general anaesthesia, and is probably normal for the anaesthetized foetus. Since continuous intraoperative monitoring of foetal heart rate in pregnant patients is technically feasible during peripheral surgery and during many intra-abdominal procedures, attempts should be made to monitor foetal heart rate in all anaesthetized parturients to assure that the anaesthetic is not causing foetal insult. Postoperative monitoring of uterine tone is useful in the diagnosis and treatment of postoperative premature labor.
Résumé
La surveillance des contractions utérines par toco-dynamomètre ainsi que la surveillance du coeur fatal ont été étudiées chez cinq patientes enceintes subissant une chirurgie urgente ou semi-urgente non reliée à leur état gravide. Toutes les patientes ont regu de I’anesthésie générale avec I’halothane ou l’ enflurane avec du protoxyde d’azote. La perte du “beat-to-beat variation” du coeur foetal a été observée chez toutes les patientes subissant I’anesthésie générate, ce qui serait normal pour le foetus anesthésié. Etant donné que la surveillance intraopéra-toire du coeur foetal chez les femmes enceintes est techniquement possible lors d’une chirurgie périphérique et plusieurs procédures intraabdominales, des tentatives doivent être accomplies afin de surveiller le coeur foetal chez toutes les patientes pour être sûr que la technique anesthésique ne provoque aucune insulte foetale. La surveillance du tonus utérin en période postopératoire est utile dans le diagnostic et le traitement d’un travail prématuré postopératoire.
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Liu, P.L., Warren, T.M., Ostheimer, G.W. et al. Clinical Reports Foetal monitoring in parturients undergoing surgery unrelated to pregnancy. Can Anaesth Soc J 32, 525–532 (1985). https://doi.org/10.1007/BF03010803
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DOI: https://doi.org/10.1007/BF03010803