Haemodynamic Changes Associated With Labour

Central circulatory responses in normotensive and hypertensive pregnancy

“…Data for cardio-pulmonary blood volume values are given in Table 4. The physiological changes which occur in the primigravid patient in response to pregnancy have been outlined in detail previously (Lees et al, 1967a(Lees et al, , b, 1968(Lees et al, , 1970. Ueland, Novy and Metcalfe (1972) have shown that in certain Datients at or Just past term there may be a slight further reduction in cardiac output, probably explained by the fact that the weight of the gravid uterus at this time is increased.…”

“…Throughout labour it has been shown ) that cardiac output may rise by as much as 40% in patients who have traditional analgesia. Lees et al (1970) have shown that where epidural analgesia has been given, there is no cumulative rise in cardiac output throughout labour. Various studies have been carried out during Caesarean section and have been previously reviewed (Lees et al, 1968).…”

Anaesthetic considerations in a parturient with critical coronary artery disease and a drug-eluting stent presenting for caesarean section

“…5 Labour results in further increases in heart rate, cardiac output and systemic vascular resistance over and above those of pregnancy 23 with an increase in central venous pressure and pre-load during contractions. 24 These changes increase the myocardial oxygen demand and may precipitate cardiac failure in some patients with poor ventricular function. Anxiety and pain, which may be difficult to control fully without epidural analgesia, act to increase cardiac work further due to catecholamine release.…”

Maternal haemodynamics in pregnancy

“…As a result the 300-500ml of blood squeezed out of the uteroplacental circulation with each contraction will cause a sudden increment in cardiac preload. 98 The fluctuations in cardiac output during labour are mitigated in the lateral position, 96 dampened when regional anaesthesia is employed 99 and largely avoided during caesarean section under epidural anaesthesia. 100101 The circulatory changes following delivery are modified by the amount of blood loss.…”