Maternal clozapine treatment and decreased fetal heart rate variability

Results:At 37 weeks’ gestation, the patient had active labor. Fetal heart rate recordings during active labor showed a decreased variability with accelerations and no decelerations. Opiate medications were not administered during labor. Delivery was normal. The newborn’s birth weight, Apgar scores and uterine artery cord pH were normal. AdverseEffects:1 fetus whose mother received Leponex during pregnancy developed decreased heart rate variability. AuthorsConclusions:In the absence of any apparent cause to explain the decreased FHR [fetal heart rate] variability, and in the presence of good neonatal outcome, we suspect that the clozapine had affected the fetal central nervous system, temporarily. A prospective study is needed in a large group of patients to evaluate the effect of clozapine on FHR variability and on neonatal outcome. Indications:1 female patient with schizophrenia. Patients:One 31-year-old pregnant female patient. TypeofStudy:The decreased heart rate variability in a fetus whose mother had been receiving Leponex during pregnancy for schizophrenia is described. Case report. DosageDuration:Dosage not stated. Duration: 7 years. FreeText:The patient was diagnosed with schizophrenia at 22 years of age and had been treated with Leponex for the last 7 years. Both former pregnancies had been uneventful and proceeded to term with the birth of healthy infants. Tests: cardiotocography for fetal heart rate determination. © 2002 International Federation of Gynecology and Obstetrics.