Antepartal uterine hypercontractility secondary to nipple stimulation

An alarming result was noted in conjunction with a nipple stimulation contraction stress test. In a 42-week pregnant woman with suspected postmaturity, gentle self-stimulation of the right nipple through the clothing for one to 1.5 minutes caused the sudden onset of uterine hypercontractility, increased uterine tone, and severe fetal bradycardia. The bradycardia persisted for approximately five minutes despite supportive measures. Operative delivery was being considered when the fetal heart rate returned to a normal baseline. Ultimately, the patient delivered vaginally without further significant complication. This experience demonstrated that carefully controlled breast stimulation may result in unpredictable uterine hyperstimulation with fetal bradycardia.