Epidural analgesia and cardiac output in severe pre-eclamptics

Labour and delivery cardiac output was assessed by thermal dilution in ten severe pre-eclamptics who received lumbar epidural analgesia. Control cardiac output was 8.8 litres/min which remained statistically unchanged following administration of lumbar epidural analgesia. At birth and delivery of the placenta, there was a moderate increase in cardiac output which increased significantly (28%) by 15 min after delivery of the placenta. Subsequently over the next hour, cardiac output returned toward baseline levels. Mother and fetus were stable throughout and infant Apgar scores were good. These results emphasise that lumbar epidural analgesia has little effect on cardiac output in severe pre-eclamptics.