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Review
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Parenteral/Systemic Anesthesia: Fetal Effects

Parenteral analgesia is a viable option for

laboring women who require pain relief.
However, the nurse should understand that
any parenteral medication given to the
woman will cross the placenta and can
affect the fetus. The effects can be direct or
indirect. Intravenous sedation that results
in decreased fetal heart rate (FHR)
variability is an example of a direct
effect. An indirect effect would be a
medication that caused maternal
hypotension resulting in decreased
placental blood flow and fetal hypoxia. The
decision to use parenteral analgesia should
be made by taking into consideration
assessment findings on the fetal heart
tracing. Tracings with an abnormal baseline, repetitive late or variable decelerations, or
minimal or absent variability are contraindications for parenteral analgesia. Administering
parenteral analgesia close to the time of birth can result in respiratory depression in the
neonate. This could require resuscitation efforts at birth including administration of Narcan
(naloxone), a narcotic antagonist, to reverse the neonates respiratory depression.