Effect of epidural anesthesia in labor; pregnancy with cardiovascular disease.

OBJECTIVE: We studied the effect and safety of epidural anesthesia during labor in pregnant women with cardiovascular disease.

MATERIALS AND METHODS: In the pregnant women with cardiovascular disease, we compared maternal outcome and suppressive effect on blood pressure retrospectively between the epidural group (anesthetized epidurally during labor) and the no-epidural group (not anesthetized epidurally during labor).

RESULTS: A total of 277 patients were included in the analyses. Cardiovascular events decreased significantly in epidural group (P < 0.05). Cardiovascular events occurred in 12 (epidural group) and 2 (no-epidural group) of cases (P < 0.05). Cardiovascular events are all events related to arrhythmia. In the epidural group, the systolic blood pressure showed no increase in labor (110.5 mmHg, 95% CI; 95-132 mmHg vs. 110 mmHg, 95% CI; 91-130 mmHg). In the no-epidural group, the systolic blood pressure increased in labor (107 1 mmHg, 95% CI; 96-138 mmHg vs. 123 mmHg, 95% CI; 105-153 mmHg; P < 0.05).

CONCLUSION: Epidural anesthesia had decrease of the cardiovascular events related to arrhythmia and the effect of significantly suppression raising the blood pressure during labor in pregnant women with cardiovascular disease. In pregnant women with the cardiovascular disease, epidural anesthesia during labor may be available.