Abstract
A hemodynamic evaluation was performed in 12 patients undergoing repeat cesarean section at term under subarachnoid block anesthesia. It was found that posture exerted a profound influence on maternal cardiodynamics in late pregnancy. Following spinal anesthesia, a decline in blood pressure invariably occurred in the supine position. This hypotension could be completely reversed by turning the patient on her side. The degree of maternal hypotension could not be related to anesthetic dose or level of anesthesia. Delivery resulted in a 52 per cent increase in cardiac output. 11 per cent decrease in heart rate, and a 67 per cent increase in stroke volume. Cesarean section under spinal anesthesia seems contraindicated in the pregnant patient with heart disease because of the extensive cardiovascular changes encountered.
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