Table 1.

Physiological changes of concern in a parturient with cardiac disease

SI. No.	Maternal cardiac parameter	Physiologic change
1	Uterine blood flow	7–10% increase
2	Red blood cell mass	20–30% increase
3	Plasma volume	45–55% increase
4	Systemic vascular resistance	35% decrease in second trimester 20% less than baseline at term
5	Cardiac output	30% increase in second trimestery 60% increase during labor Cardiac output increases immediately following delivery by 60–80%, due to uterine contraction and release of the aortocaval compression by the gravid uterus, rapidly declining to prelabor values 1 hour postpartum.
6	Heart rate	17% increase
7	Pulmonary vascular resistance	34% decrease
8	Colloid oncotic pressure (COP)	14% decrease
9	COP—pulmonary capillary wedge pressure (PCWP)	28% decrease
10	Mean arterial pressure (MAP), central venous pressure (CVP), Left ventricular stroke work index	No statistically significant change