Nipple stimulation in late pregnancy causing uterine hyperstimulation and profound fetal bradycardia

O. A C Viegas, S. Arulkumaran, D. M F Gibb, S. S. Ratnam

Research output: Contribution to journalArticlepeer-review


The oxytocin challenge test is potentially dangerous to the fetus in that it may cause hyperstimulation of the uterus. This is caused by a reaction of the myometrium to exogenous oxytocin. As an alternative, some investigators have recommended nipple stimulation, which releases endogenous oxytocin. There are, however, disadvantages to this method also. The present authors report three patients in whom nipple stimulation induced marked uterine hypertonus, resulting in profound bradycardia in fetuses otherwise demonstrating reactive heart rate patterns. Patient 1, a 35-year-old Filipino woman, was seen in the 41st week of an otherwise normal third pregnancy. An antepartum cardiotocogram was performed because of recent weight loss. Nipple stimulation during the fetal heart rate recording resulted in uterine hypertonus and a change in fetal heart response from a reactive pattern to profound bradycardia (Fig. 1a). Immediate cesarean section resulted in the birth of a normal male, weighing 3200 gm with Apgar scores of 9 and 10 at 1 and 5 minutes, respectively. AmnJotic fluid was clear, and there were no placental.

Original languageEnglish
Pages (from-to)685-686
Number of pages2
JournalObstetrical and Gynecological Survey
Issue number11
Publication statusPublished - 1984


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