Which of the following type of anesthesia is frequently associated with fetal bradycardia: (LQ)
a. Pudendal block is the most common form of anesthesia used for vaginal delivery.
b. It provides adequate pain relief for episiotomy, spontaneous delivery forceps delivery, or vacuum extraction.
c. The success of a pudendal block depends on a clear understanding of the anatomy of the pudendal nerve and its surroundings. Complications (vaginal hematomas, retro psoas, or pelvic abscesses) are quite rare.
d. Paracervical block was a popular form of anesthesia for the first stage of labor until it was implicated in several fetal deaths. It has been shown that paracervical block was associated with fetal bradycardia in 25 to 35% of cases, probably the response to rapid uptake of the drug from the highly vascular paracervical space with a resultant reduction of uteroplacental blood flow. Death in some cases was related to direct injection of the local anesthetic into the fetus.