1. Obstetrical indications |
Abnormal fetal heart rhythm |
Fetal distress |
Severe postpartum hemorrhage (i.e., hemorrhage associated with blood transfusion, hysterectomy, or disseminated intravascular coagulation) |
Abruptio placenta, placenta praevia, or placenta accrete |
Uterine rupture |
Umbilical cord prolapse |
Amniotic fluid embolism |
2. Maternal indications |
Comorbidity index for obstetric patients ≥ 3 |
Charlson comorbidity index ≥ 2 |
3. Contraindications to neuraxial techniques |
Coagulation factor deficit, Von Willebrand disease, or thrombocytopenia |
Sepsis and septic shock |
Maternal pyrexia or generalized infection during labor |
Chorioamnionitis |