Amer J Perinatol
DOI: 10.1055/s-0037-1606368
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Hemodynamics of Labor in Women Undergoing Vaginal and Cesarean Deliveries as Determined by Whole Body Bioimpedance

Eran Ashwal1, 2, Shiri Shinar2, 3, Sharon Orbach-Zinger2, 4, Shaul Lev2, 4, Roi Gat1, 2, Liron Kedar1, 2, Yehuda Pauzner2, Amir Aviram1, 2, Yariv Yogev2, 3, Liran Hiersch2, 3
  • 1Helen Schneider Hospital for Women, Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel
  • 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 3Lis Maternity Hospital, Obstetrics and Gynecology, Sourasky Medical Center, Tel Aviv, Israel
  • 4Department of Anesthesia, Rabin Medical Center, Petah Tikva, Israel
Further Information

Publication History

05 April 2017

07 August 2017

Publication Date:
30 August 2017 (eFirst)

Abstract

Objective The objective of this study was to assess the hemodynamics of labor, delivery, and 48 hours postpartum in women undergoing vaginal and cesarean deliveries by utilizing a whole body bioimpedance-based device.

Methods A prospective longitudinal single-center observational study was performed between September 2014 and September 2015. The hemodynamics of low-risk women undergoing spontaneous vaginal delivery were compared with those undergoing elective cesarean sections. Cardiac index (CI), stroke index, total peripheral resistance index (TPRI), and mean arterial pressure (MAP) were assessed at different time points during delivery and in the immediate postpartum period (1, 24, and 48 hours postpartum).

Results Eighty-seven women were evaluated, 63 parturients in the vaginal delivery group and 24 in the cesarean delivery group. Normal vaginal delivery was characterized by a reduction in MAP and CI after epidural anesthesia, whereas elective cesarean sections were characterized by a rise in MAP and CI after spinal anesthesia. As labor progressed, CI increased reaching its peak during the second stage. Immediately following delivery, TPRI declined to its nadir with no significant change in CI. As opposed to vaginal delivery, in cesarean delivery, TPRI peaked within 1-hour postpartum resulting in a significant decline in CI.

Conclusion Whole body bioimpedance can be used effectively to assess the hemodynamics of vaginal and cesarean deliveries.

Funding

None.