Blood pressure and fetal heart rate changes with patient-controlled combined spinal epidural analgesia while ambulating in labour

British Journal of Obstetrics and Gynaecology
R al-MuftiB Morgan

Abstract

To determine the effect of patient-controlled combined spinal epidural analgesia (PCEA) on maternal pulse and blood pressure, and fetal heart rate in primigravid women, when adapting different positions in labour. A prospective study. Queen Charlotte's and Chelsea hospital, London. Fifty-five primigravid women in labour at > or = 37 weeks of gestation; 40 women had supervised standing top-ups given by an anaesthetist. A further 15 women had PCEA top-ups given in each of standing, sitting and lying positions. Maternal pulse rate, blood pressure and fetal heart rate changes following epidural top-ups. In the first 40 women there was no clinically significant fall in their blood pressure (< 5 mmHg). The subsequent 15 women who had PCEA top-ups had no fall in blood pressure in the standing and sitting positions, though the average blood pressure fell significantly when a top-up was given in the lying position. Maternal heart rate increased significantly at 12 min post top-up when the women were in the standing position (P = 0.0018). In the 15 women who had PCEA top-ups, the CTG showed improvement in decelerations when women were in the standing position but deterioration when in the lying position (P < 0.01). Patient-controlled epi...Continue Reading

References

Aug 26, 1978·British Medical Journal·A M FlynnP F Lynch
Jan 1, 1974·Anesthesiology·K L Eckstein, G F Marx
Mar 1, 1995·British Journal of Obstetrics and Gynaecology·A ShennanM de Swiet
Oct 1, 1993·British Journal of Obstetrics and Gynaecology·A H ShennanM de Swiet
Apr 1, 1993·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P J AndrewsM M Juneja
Apr 1, 1994·International Journal of Obstetric Anesthesia·R E CollisB M Morgan

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Citations

Jan 7, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Roanne Preston
Jun 10, 1995·Lancet·A ShennanB Morgan
Oct 3, 2006·Current Opinion in Anaesthesiology·H A Muir
Sep 28, 2001·European Journal of Obstetrics, Gynecology, and Reproductive Biology·G Capogna
May 6, 2006·Annales Françaises D'anesthèsie Et De Rèanimation·A-S Ducloy-BouthorsM Cuisse
May 15, 2002·Seminars in Perinatology·Scott M Drysdale, Holly Muir
Apr 18, 2003·Anesthesiology Clinics of North America·Michael Paech

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