Why the study?
Does an intravenous load of Hartmann's solution reduce abnormalities of fetal heart rate and maternal hypotension in patients receiving lumbar epidural analgesia in labour?
Does an intravenous load of Hartmann's solution reduce abnormalities of fetal heart rate and maternal hypotension in patients receiving lumbar epidural analgesia in labour?
Preloading with 1 L of Hartmann's solution before epidural analgesia in labour significantly reduces the incidence of fetal heart rate abnormalities and maternal hypotension.
Fluid preloading was associated with fewer fetal heart rate abnormalities and maternal hypotension during labor epidurals; hypothesis-generating and requires randomized confirmation.
Fetal heart rate (FHR) was recorded and maternal blood pressure measured in 104 patients in whom lumbar epidural analgesia was induced in labour. Fifty-one patients received an intravenous load of 11 of Hartmann's solution immediately before the epidural injection. This infusion significantly reduced the incidence of abnormalities of FHR from 34% to 12% and of maternal hypotension from 28% to 2%. We did not study mothers with pre-eclampsia and hypertension, but we conclude that there is a strong case for preloading all other mothers in whom lumbar epidural analgesia is induced in labour.
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Collins et al. (1978) studied this question.
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