Pulse Pressure and Post-epidural Fetal Heart Rate Changes
Status:
Completed
Trial end date:
2016-11-01
Target enrollment:
Participant gender:
Summary
Epidural anesthesia, the most common method of pain control in labor, can contribute to
alterations in maternal blood pressure and/or fetal heart rate changes. As a result, the
administration of an IV fluid bolus ("preload") is standard prior to epidural placement.
However, the optimal volume of preload is unknown and no clinical trials have evaluated a
risk-factor based approach to dosing. Studies in the critical care, trauma, and obstetric
literature have suggested that a narrow pulse pressure (difference between systolic and
diastolic blood pressures) is a marker of reduced intravascular volume status and may
identify women at a higher risk for new onset fetal heart rate changes after epidural
placement. Therefore, the purpose of this study is to assess if an increased IV fluid preload
bolus among women with a narrow pulse pressure reduces the risk of new onset fetal heart rate
changes after epidural placement.