title: Uterine artery, umbilical, and fetal cerebral Doppler velocities after epidural analgesia during labor.
abstract: OBJECTIVE
  To evaluate the effects of epidural analgesia on uterine artery, umbilical, and fetal cerebral Doppler velocities during labor.
  
  
  METHODS
  In a prospective study at Beaujon Hospital, Paris, France, between September and December 2010, uterine artery, umbilical, and fetal cerebral Doppler flow velocities were measured in 12 pregnant women during spontaneous labor with epidural analgesia. The data were registered in a period of uterine relaxation before, and 20 and 60 minutes after the first administration of epidural analgesic drugs. The changes in Doppler velocimetry values and fetal heart rate after epidural analgesia were analyzed.
  
  
  RESULTS
  Uterine artery velocities, but neither umbilical nor fetal cerebral Doppler velocities, were decreased significantly at 20 minutes and 1 hour after epidural analgesia (P<0.005). Women with the greatest decrease in uterine artery Doppler flow velocities delivered neonates with the lowest values of umbilical artery blood pH.
  
  
  CONCLUSIONS
  The data suggest that the Doppler flow velocity of uterine arteries is affected by epidural analgesia during labor. Numerous Doppler flow studies of the effect of neuraxial blockade during labor on umbilical and uterine arteries have been published with incredibly variable and inconsistent results.
authors.affiliation: Department of Obstetrics and Gynecology, Paris 7-Denis Diderot University, Beaujon Hospital, Paris, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Valentin
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ducarme
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Ceccaldi
authors.forename: Bernard
authors.initials: B
authors.lastname: Bougeois
authors.forename: Dominique
authors.initials: D
authors.lastname: Luton
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D054022:Cerebrum / Q000098:blood supply*; D005260:Female; D005333:Fetus / Q000098:blood supply / Q000187:drug effects*; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy; D007743:Labor, Obstetric / Q000187:drug effects; D017078:Laser-Doppler Flowmetry; D021041:Placental Circulation / Q000187:drug effects*; D011247:Pregnancy; D011446:Prospective Studies; D014469:Umbilical Arteries / Q000187:drug effects; D055988:Uterine Artery / Q000187:drug effects; D055815:Young Adult