Maternal Hemodynamic Monitoring in Obstetric Anesthesia

THE physiologic changes of pregnancy, including an initial gradual increase in cardiac output, followed by the development of increasing aortocaval compression in the third trimester, as well as comorbidities such as preeclampsia, have generated considerable research into maternal hemodynamics. The use of the pulmonary ar-tery catheter allowed a better understanding of the phys-iology of the healthy parturient1 and the hemodynamics of preeclampsia, including the effects of epidural anal-gesia in labor.2 Early use of dye dilution techniques gave clinicians insight into the hemodynamic changes during spinal anesthesia for cesarean delivery.3 In sharp con-trast with these invasive measures is the use in the current issue of ANESTHESIOLOGY, by Langesæter et al.,4 of minimally invasive pulse waveform analysis in the assess