Publication: Uterine Tachysystole with Prolonged Deceleration Following Nipple Stimulation for Labor Augmentation
Date
2015
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Breast stimulation for inducing uterine contractions has been reported in the
medical literature since the 18th century. The American college of Obstetricians and
Gynecologists (ACOG) has described nipple stimulation as a natural and inexpensive
nonmedical method for inducing labor.
We report on a 37 year old P2 with a singleton pregnancy at 40 weeks gestation
who developed tachysystole with a prolonged deceleration after nipple stimulation
for augmentation of labor. Initial resuscitative measures, including oxygen by
mask, a bolus of intravenous fluids and left lateral positioning, did not restore
the fetal heart rate to normal. After the administration of Terbutaline 250 mcg
subcutaneously, the tachysystole resolved and the fetal heart rate recovered after
five minutes of bradycardia.
Most trials of nipple stimulation for induction or augmentation of labor have had
small study populations, and no conclusions could be drawn about the safety of
nipple stimulation, though its use is widespread. While there have been a few
reports of similar complications during nipple stimulation for contraction stress
testing, there are no previous reports of tachysystole with sustained bradycardia
following nipple stimulation for labor augmentation.
In this report, we draw attention to the dangers of nipple stimulation so that
providers will be aware of this potential complication.
KEY WORDS
Deceleration, labor, nipple stimulation, uterine tachysystole.
Description
Narasimhulu DM, Zhu L
Department of Obstetrics and Gynecology
Maimonides Medical Center
4802, 10th ave, Brooklyn, New York
Keywords
Deceleration, Labor, Nipple stimulation, Uterine tachysystole