Effects of extradural anaesthesia on umbilical and uteroplacental arterial flow velocity waveforms

Abstract

Flow velocity waveforms were recorded from the umbilical artery and uteroplacental arterial circulations of 15 women undergoing elective Caesar-ean section under extradural anaesthesia. The systolic: diastolic ratios of the flow velocity waveform were determined before and after extradural block. Extradural block did not alter fetal or maternal heart rates; however, umbilical artery systolic : diastolic ratio decreased from a mean (so) of 2.4 (0.42) to 2.26 (0.38) (P = 0.049). There were no significant changes in the uteroplacental systolic: diastolic ratios. These results were compared with those from a control group in which no statistically significant changes in maternal and fetal systolic .diastolic ratios or heart rates were observed. The application of a pulse correction factor to standardize the data to fixed maternal and fetal heart rates had little effect on the significance of the findings. Extradural block in normal pregnant women during late gestation was associated with a small reduction in bilical artery systolic:diastolic ratios, suggesting a decrease in downstream fetoplacental vascular resistance. © 1991 British Journal of Anaesthesia.