Cardiac output monitoring during vaginal delivery

Hemodynamics of Phenylephrine Infusion Versus Lower Extremity Compression During Spinal Anesthesia for Cesarean Delivery

“…During labour contractions, pain and physical strain expose the mother to haemodynamic stress, but the evidence base is limited since only a few studies have investigated the haemodynamic effects of labour. [9][10][11][12][13][14][15][16][17][18] Women delivering by elective CD escape contractions, but may suffer from spinal hypotension, i.e. a decrease in blood pressure which is a frequent side effect of spinal anaesthesia.…”

“…Hence, the literature is sparse and inconsistent. 18,49 Most studies date back to the period between the 1950s and the 1970s, and some are based on very low patient numbers. [9][10][11][12][13][14][15][16] To our knowledge, none of the previous studies provided continuous CO monitoring during all labour stages.…”

“…Techniques of the past involved central venous and arterial catheterisation, and allowed serial single CO measurements using various types of dye dilution. Suffering from disadvantages such as a high degree of invasiveness, a low number of measurements per time, limited reliability for the detection of rapid changes, and high sensitivity to noise, 18 they have been employed in only a few studies in the obstetric context. [9][10][11][12][13][14][15][16]55 Hence, haemodynamic pathophysiology during labour, and during vaginal and caesarean delivery, has been sparsely elucidated for a long time.…”

“…[9][10][11][12][13][14][15][16]55 Hence, haemodynamic pathophysiology during labour, and during vaginal and caesarean delivery, has been sparsely elucidated for a long time. 18,27,49 Thanks to the recent development of modern noninvasive and minimally invasive devices, haemodynamic monitoring in parturients has evolved over the past decade. 53 Modern CO monitors are based on transthoracic or whole-body electrical impedance, finger-cuff plethysmography, ultrasound, or peripheral arterial catheterisation and arterial wave form analysis, facilitating advanced pathophysiological insight while avoiding the risks of historic invasive techniques.…”

“…conditions. 18 He himself used bio-impedance in 10 healthy parturients, and found an increase in CO (by 84%) during stage 1 contractions. This was mainly caused by an increase in SV, which the author attributed to adrenergic stimulation and blood redistribution from the uterus.…”