The reported risk of nonreassuring fetal heart trace following neuraxial analgesia is 3-23%. This variability may be due to fluid and oxytocin management prior to and during the initiation of neuraxial analgesia. The study hypothesis is that decreasing the oxytocin infusion rate by 50 % prior to initiation of combined spinal epidural analgesia will cause a reduction in the incidence of adverse fetal heart rate changes.
Healthy nulliparous or multiparous women at term (37 > weeks' gestation)
Singleton pregnancy
Request for neuraxial analgesia
Oxytocin used for induction of labor or augmentation of labor per institutional protocols
Use of chronic analgesic medications
Prior administration of systemic opioid labor analgesia
Non-vertex presentation
Contraindication to neuraxial analgesia
Unyime Ituk
Lead sponsor
University of Iowa
Sponsor institution