Maternal Cardiovascular Dynamics Iii. Labor and Delivery Under Local and Caudal Analgesia

Invasive monitoring and anaesthetic management of a parturient with mitral stenosis

“…If control of the heart rate cannot be achieved with oral propanolol, intravenous administration of this drug may be necessary, Epidural anaesthesia may have contributed to the successful control of HR during labour as it prevents increases in sympathetic activity secondary to pain. 3 This case report, as well as the series reported on by Clark etal., illustrates the necessity of measuring the PAP in parturients with clinically significant mitr',d stenosis, since the PCWP cannot be predicted from the CVP. Wc found the information provided by the pulmonary artery catheter invaluable in guiding our fluid managemenl during the induction and maintenance of epidural anaesthesia and throughout the conduct of labour.…”

Haemodynamic effects of induction of epidural analgesia in labour

“…analgesia with 0. 5 Impairment of uterine blood flow (UBF) during labour is an hnportaul cause of fetal asphyxia and neonatal mortality and morbidity. Direct measurement of UBF in humans, requiring either vascular canuulation or radio-isotope techniques, is limited by ethical considerations.…”

Short communication: Is intrapartum temporary pacing required for women with complete atrioventricular block? An analysis of seven cases

“…However, in women with CAVB, in whom a sufficient increase in heart rate cannot be expected, their increased output across pregnancy and in labour mostly depends on altered stroke volume. We wondered whether the haemodynamic status of women with CAVB without a permanent pacemaker implanted would remain stable during and immediately after labour and birth, particularly in the setting of the increased cardiac workload in labour [13][14][15][16] or in the presence of acute blood loss postdelivery. In the 1950s, it was suggested that without pacemaker insertion, pregnancy in women with CAVB was associated with high maternal and fetal mortality.…”