During labor, a primigravid client receives an epidural anesthesia. Which finding would best suggest an adverse reaction to the anesthesia?

• A. Maternal hypotension
• B. Fetal tachycardia
• C. Maternal hypertension
• D. Elevated temperature

Answer: (A)

Maternal hypotension is the hallmark adverse effect of epidural anesthesia in labor. The epidural block can cause sympathetic nerve blockade in the lower body, leading to systemic vasodilation and decreased venous return. This drops the mother’s blood pressure and can reduce uteroplacental blood flow, risking fetal distress. That immediate hemodynamic change is the best sign that the epidural is causing an adverse reaction.

Other findings are less directly tied to the epidural. Fetal tachycardia can indicate fetal distress from various causes, but it isn’t a direct consequence of the epidural block itself. Maternal hypertension goes against the expected effect of a sympathetic block, and an isolated elevated temperature isn’t a typical acute reaction to the anesthesia. If hypotension occurs, management focuses on increasing IV fluids and using a vasopressor (like phenylephrine or ephedrine) while monitoring both mother and fetus.