Advertisement

Fetal heart rate mirrors maternal temperature during posterior fossa craniotomy: a case report

      Highlights

      • Maternal hypothermia may affect baseline fetal heart rate and variability.
      • Differential diagnosis for fetal heart rate changes includes maternal temperature.
      • Maternal temperature should be monitored and regulated during non-obstetric surgery.

      Abstract

      While it is well known that maternal temperature affects fetal heart rate, the exact relationship is not well described. The circumstances accompanying most cases of maternal hypothermia and rewarming (e.g. a drowning event) have precluded a precise quantitative description of this relationship. We describe hypothermia and controlled rewarming during resection of a maternal brain stem tumor in the early third trimester. Continuous electronic fetal heart rate and core temperature monitoring demonstrated a near linear relationship during the development of hypothermia and rewarming. Recognition of the close relationship between maternal temperature and fetal heart rate can help safeguard maternal and fetal health, and prevent unnecessary delivery during non-obstetric surgery in pregnancy.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to International Journal of Obstetric Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aboud E.
        • Neales K.
        The effect of maternal hypothermia on the fetal heart rate.
        Int J Gynaecol Obstet. 1999; 66: 163-164https://doi.org/10.1016/S0020-7292(99)00058-2
        • Hankins G.
        • Leicht T.
        • Van Hook J.
        Prolonged fetal bradycardia secondary to maternal hypothermia in response to urosepsis.
        Am J Perinatol. 1997; 14: 217-219https://doi.org/10.1055/s-2007-994130
        • Rodis J.F.
        • Vintzileos A.M.
        • Campbell W.A.
        • Deaton J.L.
        • Nochimson D.J.
        Maternal hypothermia: an unusual complication of magnesium sulfate therapy.
        Am J Obstet Gynecol. 1987; 156: 435-436https://doi.org/10.1016/0002-9378(87)90300-0
        • Mann D.G.
        • Nassr A.A.
        • Whitehead W.E.
        • Espinoza J.
        • Belfort M.A.
        • Shamshirsaz A.A.
        Fetal bradycardia associated with maternal hypothermia after fetoscopic repair of neural tube defect.
        Ultrasound Obstet Gynecol. 2018; 51: 411-412https://doi.org/10.1002/uog.17501
        • Jadhon M.E.
        • Main E.K.
        Fetal bradycardia associated with maternal hypothermia.
        Obstet Gynecol. 1988; 72: 496-497
        • Arun O.
        • Taylan S.B.
        • Duman I.
        • et al.
        In vitro vasoactive effects of dexmedetomidine on isolated human umbilical arteries.
        Bratisl Med J. 2019; 120: 40-45https://doi.org/10.4149/BLL_2019_006
        • Sia A.T.
        • Kwek K.
        • Yeo G.S.
        The in vitro effects of clonidine and dexmedetomidine on human myometrium.
        Int J Obstet Anesth. 2005; 14: 104-107https://doi.org/10.1016/j.ijoa.2004.11.004
        • Palanisamy A.
        • Klickovich R.J.
        • Ramsay M.
        • Ouyang D.W.
        • Tsen L.C.
        Intravenous dexmedetomidine as an adjunct for labor analgesia and cesarean delivery anesthesia in a parturient with a tethered spinal cord.
        Int J Obstet Anesth. 2009; 18: 258-261https://doi.org/10.1016/j.ijoa.2008.10.002
        • Mendoza-Villa J.M.
        Dexmedetomidine as adjunct for analgesia in labor: a report of two cases.
        Rev Col Anest. 2011; 40: 79-81
        • Handlogten K.S.
        • Sharpe E.E.
        • Brost B.C.
        • Parney I.F.
        • Pasternak J.J.
        Dexmedetomidine and mannitol for awake craniotomy in a pregnant patient.
        Anesth Analg. 2015; 120: 1099-1103https://doi.org/10.1213/ANE.0000000000000710
        • Uemura K.
        • Shimazutsu K.
        • McClaine R.J.
        • et al.
        Maternal and preterm fetal sheep responses to dexmedetomidine.
        Int J Obstet Anesth. 2012; 21: 339-347https://doi.org/10.1016/j.ijoa.2012.06.010
        • Lépiz M.L.
        • Sayre R.
        • Sawant O.
        • et al.
        Maternal and fetal effects of dexmedetomidine infusion in pregnant ewes anesthetized with sevoflurane.
        Am J Vet Res. 2017; 78: 1255-1263https://doi.org/10.2460/ajvr.78.11.1255