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This is probably due to reduced ventricular preload.
The improvement in intervillous -ow observed following epidural analgesia with local anaesthetic during labour28 is not the result of a large intravenous preload.
This increase may be partially offset by a compensatory increase in mean atrial pressure (preload).
Understandably, the reduction in preload may reduce stroke volume and cardiac output.
Furthermore, because the total effect of preload on shortening is considered, both preload-induced alterations in contractility and direct mechanical effects are included in the analysis.
This is achieved by increase in cardiac rate and contractility, maintenance of preload, and reduction of afterload.
In the latter, useless right ventricular dilatation may result from a "retrograde" preload in response to pulmonary regurgitation.
Randomized controlled study of colloid preload before spinal anaesthesia for caesarean section.
