Am J Perinatol 2014; 31(01): 085-090
DOI: 10.1055/s-0033-1334448
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Morphine Sleep in Pregnancy

A. Dhanya Mackeen
1   Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
,
Eric Fehnel
1   Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
,
Vincenzo Berghella
1   Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
,
Thomas Klein
1   Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

18 July 2012

31 December 2012

Publication Date:
07 March 2013 (online)

Abstract

Objectives To determine the incidence of admission in labor after morphine sleep (therapeutic rest), patient characteristics associated with labor, and adverse outcomes associated with treatment.

Methods We reviewed medical records of women treated with morphine sleep from December 2005 to December 2009. Variables evaluated included medications used for treatment, cervical examination, maternal demographic characteristics and obstetric history, fetal heart rate patterns, and maternal/neonatal outcomes. These characteristics were compared between those admitted in labor after morphine sleep versus those discharged.

Results Fifty-eight women received morphine sleep: 36 (62%) were admitted in labor, 17 (29%) were discharged, and 5 (9%) were admitted secondary to category II fetal heart rate tracings. All fetuses had category I fetal heart rate tracings prior to treatment. Median dose of morphine sulfate was 20 mg. Those with effacement > 50% (p < 0.01) and carrying term gestations (p < 0.01) were more likely to be admitted in labor after treatment. There were no adverse maternal outcomes. There were no significant differences in neonatal outcomes.

Conclusion Sixty-two percent of women were admitted in labor after morphine sleep. Admission effacement > 50% and term gestational age were associated with admission in labor. There were no significant differences in maternal or neonatal morbidity in those admitted versus discharged home after treatment with morphine sleep.

 
  • References

  • 1 Gabbe S , ed. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingstone; 2007
  • 2 Friedman EA, Sachtleben MR. Dysfunctional labor. I. Prolonged latent phase in the nullipara. Obstet Gynecol 1961; 17: 135-148
  • 3 Friedman EA. Labor: Clinical Evaluation and Management. In: 2nd ed. New York, NY: Appleton-Century-Crofts; 1978
  • 4 Laughon SK, Zhang J, Troendle J, Sun L, Reddy UM. Using a simplified Bishop score to predict vaginal delivery. Obstet Gynecol 2011; Apr; 117 (4) 805-11
  • 5 Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol 2008; 112: 661-666
  • 6 Greulich B, Tarrant B. The latent phase of labor: diagnosis and management. J Midwifery Womens Health 2007; 52: 190-198