Epidural space pressures during pregnancy. 1981

M N Messih

The epidural space pressure in the lumbar region was monitored and recorded in 21 full term pregnant patients, before and during labour and 6-12 hours postpartum, in different positions. The pre-labour epidural pressure was found to be above atmospheric in all patients, being highest when supine, and lowest in the lateral position. Three patients with twin pregnancy showed a greater rise in epidural space pressure in the supine position even with the use of lateral tilt, compared with patients with single fetus pregnancy. It is suggested that the epidural space pressure in the full term pregnant patient is closely related to the degree of inferior vena caval obstruction imposed by the gravid uterus. It is also suggested that when the patient is aware of a uterine contraction, the synchronous rise of the epidural space pressure with the contraction is a result of reflex increase in abdominal muscle tone. With established epidural block, and the parturient unaware of a contraction, such a rise was minimal, and was replaced by a drop in pressure in patients with a single fetus who developed loss of muscle power. The magnitude of the drop in the epidural space pressure immediately after delivery was found to be related to the duration of labour and to the mode of delivery. Epidural pressures measured 6-12 hours after delivery were comparable in all patients.

UI MeSH Term Description Entries
D007743 Labor, Obstetric The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED). Obstetric Labor
D011187 Posture The position or physical attitude of the body. Postures
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D004824 Epidural Space Space between the dura mater and the walls of the vertebral canal. Epidural Spaces,Space, Epidural,Spaces, Epidural
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000773 Anesthesia, Obstetrical A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth. Anesthesia, Gynecological,Anesthesia, Obstetric,Gynecologic Anesthesia,Paracervical Block,Anesthesia, Gynecologic,Block, Paracervical,Blocks, Paracervical,Gynecological Anesthesia,Obstetric Anesthesia,Obstetrical Anesthesia,Paracervical Blocks
D013115 Spinal Canal The cavity within the SPINAL COLUMN through which the SPINAL CORD passes. Vertebral Canal,Vertebral Foramen,Vertebral Foramina,Canal, Spinal,Canal, Vertebral,Foramen, Vertebral,Foramina, Vertebral,Spinal Canals,Vertebral Canals,Vertebral Foramens

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