Lumbar epidural analgesia and utero-placental blood flow in pregnancies complicated by hypertension

ABSTRACT

Eighteen parturient patients [15 with severe pre-eclampsia and 2 patients with chronic essential hypertension] were studied before and after lumbar epidural analgesia during first stage of labour using 10ml of 0.25% of bupivacaine. The utero-placental perfusion was evaluated by determining the systolic/diastolic [A/B] ratio in the uterine and umbilical arteries using Doppler velocimetry waveform analysis. The uterine artery systolic/diastolic [A/B ratio] decreased significantly from 1.95 + 0.45 before analgesia to 1.36 + 0.20 after it [p < 0.01]. The umbilical artery systolic/diastolic [A/B ratio] also decreased from 2.85 + 0.45 before analgesia to 2.22 + 0.53 after it [p < 0.01]. These results suggest improved utero-placental perfusion and improved intervillous blood flow after epidural analgesia which mades it the the obstetric analgesia method of choice in cases of sever pre-eclampsia