Which maternal complication requires monitoring after initiating an epidural analgesia?

• A. Hypertension
• B. Hypotension
• C. Hyperglycemia
• D. Tachycardia

Answer: (B)

When an epidural analgesia is started, the local anesthetic can block sympathetic nerves in the lower body. This causes the blood vessels to dilate and blood to pool in the legs, reducing venous return to the heart and lowering systemic blood pressure. Because maternal blood pressure directly affects placental perfusion, watching for and addressing hypotension is essential right after epidural initiation.

To protect both mother and baby, blood pressure is monitored closely, the patient is often placed in a left lateral position to optimize venous return, IV fluids may be given to maintain preload, and vasopressors are used if needed to restore pressure. Tachycardia can occur as a compensatory response to the drop in pressure, but the primary issue requiring monitoring is the development of hypotension. Hyperglycemia and tachycardia alone aren’t the central concerns in this scenario and hypertension isn’t expected from initiating epidural analgesia.