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Re: Pitocin and epiduralFrom: Cheri Van Hoover (cherivh@xdcr.com)Tue May 31 20:03:50 2005
GA12L@aol.com wrote:
> As a member of the University of California, San Francisco Faculty OB/GYN group I had the privilege of working with Mark Rosen, one of the editors of Shnider and Levinson's Anesthesia for Obstetrics. He knows a hell of a lot about obstetrics, and even more about anesthesia. This was one of the ideas that was being discussed quite a lot at UCSF when I left. Uterine hyperstimulation immediately following combined spinal/epidural procedures was being blamed for exactly the heart rate patterns described in the previous post, and that hyperstimulation was being blamed on parasympathetic blockade as a result of the rapid relief of pain. We rarely turned off the Pitocin before the epidural was administered, however. We were quick to turn it off or down when those fetal heart patterns were observed and were not surprised to see them. I haven't seen the articles supporting this practice so can't assist with that. I can only say that this does not seem to be an isolated belief. If your anesthesia team comes up with some good articles to support this practice I hope you will share them with us.
-- Cheri Van Hoover, CNM, MS Faculty, Midwifery Institute at Philadelphia University
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