The Effects of Labor Epidural Analgesia on Maternal and Fetal Hemodynamics: A Prospective Observation Study.

Abstract

This study aimed to investigate the effect of epidural analgesia (EA) on maternal and fetal hemodynamics. A prospective single-center observational study was conducted from March 2022 to May 2022 on low-risk singleton pregnancies who received prenatal care at 37-40 weeks and delivered at our hospital. Pre- and post-EA, maternal and fetal hemodynamics, including maternal parameters of mean arterial pressure (MAP), heart rate (HR) and saturation of pulse oxygen (SPO2 ), fetal heart rate (FHR), Doppler flow parameters of umbilical artery (UA), middle cerebral artery (MCA), and uterine artery (UtA) during labor were measured before epidural insertion (T0), and 15 (T1), 30 (T2), and 60 (T3) minutes after. Computational analysis was performed using a one-way ANOVA test. In total, 100 singleton pregnant women were enrolled. After EA, maternal MAP, HR, and SPO2 were significantly lower than baseline values at all times except for HR in T3 and remained lower for the study's duration (P < .05). As for FHR, there was no significant difference between pre- and post-epidural. The mean UtA-PI (pulsatility index), UA-PI, UA-RI (resistance index), and UA-S/D (systolic/diastolic ratio) were not significantly modified after EA. Nevertheless, MCA-PI and RI significantly decreased in 15 minutes after initiating EA compared with T0 values (P < .05), and MCA-PSV (resistance index and peak systolic velocities) was significantly increased compared with T0 at all times (P < .05). The above changes were all within the normal range. Although maternal MAP, HR, and SPO2 significantly decreased after EA, fetal hemodynamics remained relatively stable.