| Positional effects on maternal cardiac output during labor with epidural analgesia. | |
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MedLine Citation:
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PMID: 8885738 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our purpose was to test the hypothesis that the supine versus the lateral position is associated with a greater decrement in cardiac output after epidural analgesia in labor. STUDY DESIGN: Twenty-one normal term subjects were randomized to the left lateral or supine position in early labor. Cardiac output measured by the acetylene rebreathing method, stroke volume, heart rate, mean arterial pressure, and systemic vascular resistance were obtained at 5-minute intervals, beginning before a 500 ml intravenous fluid bolus (baseline) and ending 45 minutes after epidural injection. RESULTS: Mean baseline supine versus lateral group differences were significant for 21% lower cardiac output, 21% lower stroke volume, 19% higher mean arterial pressure, 50% higher systemic vascular resistance, and equivalent heart rate. In the supine group fluid bolus resulted in significantly increased cardiac output and stroke volume, decreased mean arterial pressure and systemic vascular resistance, and unchanged heart rate. In the supine group cardiac output and stroke volume decreased significantly after epidural injection. The lateral position group exhibited no hemodynamic alterations after fluid bolus or epidural. CONCLUSIONS: In contrast to the lateral position, the supine position is associated with a significant postepidural decrement in cardiac output, not identified by a change in heart rate. This likely reflects an inability to maintain stable preload volume in the supine position. |
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Authors:
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D R Danilenko-Dixon; L Tefft; R A Cohen; B Haydon; M W Carpenter |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 175 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1996-12-05 Completed Date: 1996-12-05 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 867-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Brown University, Women and Infants Hospital, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analgesia, Epidural* Blood Pressure Cardiac Output* Female Heart Rate Humans Labor, Obstetric* Pregnancy Stroke Volume Supine Position* Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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