Observational studyArchives of gynecology and obstetrics2023
Maternal hemodynamics and computerized cardiotocography during labor with epidural analgesia.
Observational study in Archives of gynecology and obstetrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 13 citations in OpenAlex.
- Epidural Analgesia Duration and Postpartum Blood Pressure Trajectory in Hypertensive Pregnancies: A Time-to-Event Analysis.International journal of women's health · 2026Article
- Association of epidural block analgesia combined with Low-dose oxytocin with pain intensity and delivery outcomes in primiparous women.Frontiers in pediatrics · 2026Article
- Noninvasive Hemodynamic Assessment with Impedance Cardiography During Spinal and Epidural Anesthesia in Obstetrics.Journal of clinical medicine · 2025Article
- Article
- Letter to the editor related to the article: "Maternal hemodynamics and computerized cardiotocography during labor with epidural analgesia." published by Giannubilo et al.Archives of gynecology and obstetrics · 2023Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo analyze the mechanisms involved in the fetal heart rate (FHR) abnormalities after the epidural analgesia in labor.
methodsA prospective unblinded single-center observational study on 55 term singleton pregnant women with spontaneous labor. All women recruited underwent serial bedside measurements of the main hemodynamic parameters using a non-invasive ultrasound system (USCOM-1A). Total vascular resistances (TVR), heart rate (HR), stroke volume (SV), cardiac output (CO) and arterial blood pressure were measured before epidural administration (T0), after 5 min 5 (T1) from epidural bolus and at the end of the first stage of labor (T2). FHR was continuously recorded through computerized cardiotocography before and after the procedure.
resultsThe starting CO was significantly higher in a subgroup of women with low TVR than in women with high-TVR group. After the bolus of epidural analgesia in the low-TVR group there was a significant reduction in CO and then increased again at the end of the first stage, in the high-TVR group the CO increased insignificantly after the anesthesia bolus, while it increased significantly in the remaining part of the first stage of labor. On the other hand, CO was inversely correlated with the number of decelerations detected on cCTG in the 1 hour after the epidural bolus while the short-term variation was significantly lower in the group with high-TVR.
conclusionMaternal hemodynamic status at the onset of labor can make a difference in fetal response to the administration of epidural analgesia.
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