The effect of epidural anaesthesia for caesarean section on maternal uterine and fetal umbilical artery blood flow velocity waveforms

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Abstract
The blood flow resistance in the maternal uteroplacental and fetal umbilical artery circulation was studied in eight otherwise normal patients undergoing elective lower segment caesarean section. The systolic/diastolic A/B ratio (the ratio of peak systolic to least diastolic flow velocity) for the uteroplacental and fetal umbilical circulation was determined from the artery blood flow velocity-time waveform and used as an index of blood flow resistance. Each patient received a 1 litre intravenous crystalloid infusion before an epidural bupivicaine injection. Both crystalloid infusion and epidural anaesthesia resulted in a significant decrease in the maternal uteroplacental systolic/diasolic (A/B) ratios, associted with a decrease in fetal umbilical artery A/B ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia.

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