Abstract
During cesarean delivery with neuraxial anesthesia, maternal hemodynamic changes occur with prehydration of intravenous fluid, block onset and delivery of the fetus. The direction and degree of these hemodynamic changes is influenced by multiple interacting variables including the physiologic and anatomic alterations of pregnancy, maternal and fetal characteristics, comorbid conditions, the neuraxial technique, the amount of blood loss and fluid and drug administration. In this review, the influences of each of these variables, as well as the techniques used to evaluate, prevent and treat hypotension, are discussed to provide a comprehensive overview of the cardiovascular alterations in the parturient undergoing cesarean delivery with neuraxial anesthesia.
Acknowledgements
The authors would like to thank Andres Macias of the Brigham and Women’s Hospital for his work on this project.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.