Epidural analgesia and fetal heart rate abnormalities.

Lumbar epidural analgesia is frequently associated with fetal heart rate abnormalities. Fluid preloading prior to the procedure significantly reduces the incidence of abnormal fetal heart rate patterns (p = 0.02). The mechanisms of these changes are discussed and the importance of maternal hypotension is evaluated. Fluid preloading and continuous electronic fetal monitoring should be considered routine for all women undergoing this procedure.