The Hemodynamics of Labor in Women Undergoing Vaginal and Cesarean Deliveries as Determined by Whole Body Bioimpedance

Ashwal‏, Eran; Shinar, Shiri; Orbach‐Zinger, Sharon; Lev, Shaul; Gat, Roi; Kedar, Liron; Pauzner, Yehuda; Aviram, Amir; Yogev, Yariv; Hiersch, Liran

doi:10.1055/s-0037-1606368

Cited by 3 publications

(4 citation statements)

References 29 publications

(27 reference statements)

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“…Thus far, studies investigating maternal hemodynamics during labor and delivery have yielded conflicting results, especially regarding magnitude and timing of hemodynamic adaptations. Previous studies suggested inconsistent results on the effect of EA on maternal hemodynamics during labor [19,[23][24][25][26]. EA induces a sympathetic blockade that causes vasodilatation and a decrease in venous return to the heart, which can result in maternal hypotension.…”

Section: Discussionmentioning

confidence: 99%

“…However, these effects are seen in only some of the studies and reported clinically in only 0-14% of laboring women receiving EA [23][24][25][26][27]. Recently, Ashwal et al [19] compared maternal hemodynamics following vaginal and cesarean deliveries determined by a whole body bioimpedance-based device. They found a significant decrease in cardiac index and in MAP measured before and after EA.…”

Section: Discussionmentioning

confidence: 99%

“…Although safe, these tools present logistical and cost issues and are operator dependent [16][17][18]. Over the recent years, technology has improved, allowing monitoring using whole-body bioimpedance and thoracic bioimpedance-based devices [19,20]. Both techniques are safe and easy to use; however, they still require maternal wiring, which is uncomfortable during labor.…”

Section: Introductionmentioning

confidence: 99%

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Continuous Maternal Hemodynamics Monitoring at Delivery Using a Novel, Noninvasive, Wireless, PPG-Based Sensor

Atzmon

Ishay²,

Hallak

et al. 2020

JCM

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Objective: To evaluate continuous monitoring of maternal hemodynamics during labor and delivery utilizing an innovative, noninvasive, reflective photoplethysmography-based device. Study design: The Biobeat Monitoring Platform includes a wearable wristwatch monitor that automatically samples cardiac output (CO), blood pressure (BP), stroke volume (SV), systemic vascular resistance (SVR), heart rate (HR) every 5 s and uploads all data to a smartphone-based app and to a data cloud, enabling remote patient monitoring and analysis of data. Low-risk parturients at term, carrying singletons pregnancies, were recruited at early delivery prior to the active phase. Big data analysis of the collected data was performed using the Power BI analysis tool (Microsoft). Next, data were normalized to visual presentation using Excel Data Analysis and the regression tool. Average measurements were compared before and after rupture of membranes, epidural anesthesia, fetal delivery, and placental expulsion. Results: Eighty-one parturients entered analysis. Epidural anesthesia was associated with a slight elevation in CO (5.5 vs. 5.6, L/min, 10 min before and after EA, p < 0.05) attributed to a non-significant increase in both HR and SV. BP remained stable as of counter decrease in SVR (1361 vs. 1319 mmHg⋅min⋅mL−1, 10 min before and after EA, p < 0.05). Fetal delivery was associated with a peak in CO after which it rapidly declined (6.0 vs. 7.2 vs. 6.1 L/min, 30 min before vs. point of delivery vs. after delivery, p < 0.05). The mean BP remained stable throughout delivery with a slight increase at fetal delivery (92 vs. 95 vs. 92.1 mmHg, p < 0.05), reflecting the increase in CO and decrease in SVR (1284 vs. 1112 vs. 1280 mmHg⋅min⋅mL−1, p < 0.05)with delivery. Placental expulsion was associated with a second peak in CO and decrease in SVR. Conclusions: We presented a novel application of noninvasive hemodynamic maternal monitoring throughout labor and delivery for both research and clinical use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Continuous Maternal Hemodynamics Monitoring at Delivery Using a Novel, Noninvasive, Wireless, PPG-Based Sensor

Atzmon

Ishay²,

Hallak

et al. 2020

JCM

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show abstract

“…Normal vaginal delivery (VD) with epidural analgesia is characterised by a reduction in mean arterial pressure and cardiac index [10]. Elective caesarean section (CS) with epidural anaesthesia at term is associated with significant increases in stroke volume and cardiac output following delivery of the placenta [11].…”

Section: Peripartum and Postpartummentioning

confidence: 99%

Physiological Changes and Cardiovascular Investigations in Pregnancy

Morton

2021

Heart, Lung and Circulation

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Profound physiological changes in the maternal cardiovascular system occur shortly after conception. These changes may impact upon the investigation of healthy and complicated pregnancies. Additionally, concerns regarding fetal exposure to ionising radiation are important considerations in maternal testing. This manuscript reviews the important physiological changes pertinent to the investigation of maternal cardiovascular disease in pregnancy.

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Pregnancy and Heart Disease

Valente

2021

Echocardiography in Pediatric and Congenital Heart Disease

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The Hemodynamics of Labor in Women Undergoing Vaginal and Cesarean Deliveries as Determined by Whole Body Bioimpedance

Abstract: Whole body bioimpedance can be used effectively to assess the hemodynamics of vaginal and cesarean deliveries.

Cited by 3 publications

References 29 publications

Continuous Maternal Hemodynamics Monitoring at Delivery Using a Novel, Noninvasive, Wireless, PPG-Based Sensor

Continuous Maternal Hemodynamics Monitoring at Delivery Using a Novel, Noninvasive, Wireless, PPG-Based Sensor

Physiological Changes and Cardiovascular Investigations in Pregnancy

Pregnancy and Heart Disease

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