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Updated: Apr 23, 2026

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Passive leg raising during pregnancy.

Nicole Ribeiro Marques1, Caroline Martinello1, George C Kramer1

  • 1Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas.

American Journal of Perinatology
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Passive leg raising (PLR) did not increase cardiac output in healthy pregnant women. This maneuver, even in the right lateral decubitus position, did not significantly improve hemodynamic measurements for cardiac output in the third trimester.

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Area of Science:

  • Cardiovascular Physiology
  • Obstetric Medicine
  • Hemodynamics

Background:

  • Assessing fluid responsiveness is crucial in managing pregnant patients.
  • Passive leg raising (PLR) is a noninvasive method to predict fluid responsiveness.
  • Its efficacy in healthy pregnant women during the third trimester requires further investigation.

Purpose of the Study:

  • To evaluate the impact of passive leg raising (PLR) on cardiac output in healthy pregnant women in their third trimester.
  • To determine if PLR can serve as a reliable indicator of fluid responsiveness in this population.

Main Methods:

  • Noninvasive hemodynamic monitoring was used to obtain baseline measurements in pregnant women in the semirecumbent position.
  • Measurements included heart rate, blood pressure, cardiac output, and stroke volume.
  • Measurements were repeated after a 3-minute PLR maneuver in supine, left lateral decubitus, and right lateral decubitus positions.

Main Results:

  • Passive leg raising (PLR) in the supine and left lateral decubitus positions did not significantly alter cardiac output or other hemodynamic parameters.
  • PLR in the right lateral decubitus position led to a significant decrease in heart rate, cardiac output, and cardiac index.
  • No significant increase in cardiac output was observed with PLR in any tested position.

Conclusions:

  • Passive leg raising (PLR) does not appear to be an effective method for increasing cardiac output in healthy pregnant women during the third trimester.
  • The maneuver did not demonstrate a significant preload-recruitment effect in this cohort.
  • Further research may be needed to explore alternative methods for assessing fluid responsiveness in pregnant individuals.