Abstract
Fetal bradycardia and depression at birth have previously been reported with varying frequency after paracervical block given for the relief of pain in the first stage of labor. This report concerns the death of two infants occurring after mepivacaine paracervical block. The first experienced prolonged bradycardia and was stillborn. Bradycardia in the second coincided with maternal analgesia. This infant subsequently had convulsions and died. Mepivacaine was found in the urine. Other investigators have detected mepivacaine in depressed infants born after caudal and lumbar epidural anesthesia. Rapid passage of mepivacaine into the fetal circulation, impaired detoxification in the newborn period and increased acidosis in the perinatal period have been noted. Further study of the obstetric use of local anesthetics, and especially their paracervical administration, is imperative.
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