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To our knowledge, the pharmacokinetics of epidural hydromorphone has not been evaluated in parturients.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>In this pilot study, seven healthy parturients were given a single epidural dose of hydromorphone for labour pain. One parturient received 1.5\u00a0mg, two 0.75\u00a0mg and four 0.5\u00a0mg of hydromorphone hydrochloride. Dose was decreased due to nausea and pruritus. Hydromorphone\u2019s effect, adverse effects and plasma concentrations were evaluated. Neonatal drug exposure was evaluated by umbilical vein and artery opioid concentration at birth. Neonatal outcomes were assessed using Apgar and the Neurologic Adaptive Capacity Score (NACS).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All patients received additional levobupivacaine doses on parturients\u2019 requests. The first dose was requested at a median of 163\u00a0min (range 19\u2013303\u00a0min) after hydromorphone administration. A total of 12 opioid related expected adverse events were reported by seven parturients. All newborn outcomes were uneventful. Hydromorphone\u2019s distribution and elimination after single epidural dose seem similar to that reported for non-pregnant subjects after intravenous hydromorphone administration, but further research is required to confirm this observation.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The optimal dose of hydromorphone in labour pain warrants further evaluation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00228-020-02880-6","type":"journal-article","created":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T05:02:12Z","timestamp":1588482132000},"page":"969-977","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Single dose epidural hydromorphone in labour pain: maternal pharmacokinetics and neonatal exposure"],"prefix":"10.1007","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-5429","authenticated-orcid":false,"given":"Terhi","family":"Puhto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merja","family":"Kokki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henriikka","family":"Hakom\u00e4ki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Spalding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teemu","family":"Gunnar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seppo","family":"Alahuhta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merja","family":"Vakkala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,3]]},"reference":[{"key":"2880_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/j.1399-6576.1995.tb05593.x","volume":"39","author":"P Ranta","year":"1995","unstructured":"Ranta P, Spalding M, Kangas-Saarela T, Jokela R, Hollmen A, Jouppila P et al (1995) Maternal expectations and experiences of labour pain--options of 1091 Finnish parturients. 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