Effect of change in posture on maternal functional hemodynamics at 35-37 weeks' gestation
| Autor: | Gavin P. Guy, Mirian Machuca, Kypros H. Nicolaides, Hua Z. Ling, Liona C. Poon |
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| Rok vydání: | 2016 |
| Předmět: |
Gestational hypertension
Adult Cardiac output Supine position Pregnancy Trimester Third Posture Cardiac index Blood Pressure 030204 cardiovascular system & hematology Sitting Cardiography Impedance 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Heart Rate Predictive Value of Tests Pregnancy Heart rate medicine Humans Radiology Nuclear Medicine and imaging Arterial Pressure Prospective Studies Cardiac Output 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology business.industry Hemodynamics Obstetrics and Gynecology Signal Processing Computer-Assisted Stroke Volume General Medicine Stroke volume Hypertension Pregnancy-Induced medicine.disease Preload Reproductive Medicine Anesthesia Female sense organs Pregnant Women business |
| Zdroj: | Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 51(3) |
| ISSN: | 1469-0705 |
| Popis: | Objectives To evaluate the effect of posture change from the supine to the sitting position and before and after passive leg raising on maternal functional hemodynamics in pregnant women at 35-37 weeks' gestation, and to compare the changes in pregnancies that subsequently developed pre-eclampsia (PE) or gestational hypertension (GH) with those that remained normotensive. Methods In 2764 singleton pregnancies at 35-37 weeks' gestation, maternal cardiovascular parameters were measured using an automated non-invasive cardiac monitor. The hemodynamic response to a change from the supine to the sitting position and before and after passive leg raising in the left lateral position was examined and compared between women who subsequently developed PE or GH and those who remained normotensive. Results In normotensive singleton pregnancies at 35-37 weeks' gestation, both change from the supine to the sitting position and passive leg raising were associated with an increase in cardiac index and stroke volume index and a decrease in total peripheral resistance index; there was a small increase in mean arterial pressure with both postural changes and a slight decrease in heart rate with passive leg raising. In pregnancies that subsequently developed PE or GH, compared with normotensive pregnancies, cardiac index and stroke volume index were lower and total peripheral resistance index was higher. In general, change from the supine to the sitting position and passive leg raising were associated with similar but less marked changes in cardiovascular parameters as in normotensive pregnancies. Conclusions Paradoxically, in late third-trimester normal pregnancy, both change from the supine to a sitting position and passive leg raising may result in an increase in preload with a consequent increase in cardiac and stroke volume indices and a decrease in total peripheral resistance index. In pregnancies that develop PE or GH, the effects of postural change on cardiovascular parameters are similar but less marked than in normotensive pregnancies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. |
| Databáze: | OpenAIRE |
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