A Study of Cardiac Output at Rest Throughout Pregnancy

Lees, M. M.; Sh, Taylor; Scott, D.B.; Kerr, M. G.

doi:10.1111/j.1471-0528.1967.tb03956.x

Cited by 181 publications

(51 citation statements)

References 24 publications

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“…As known from human beings, the [6]. She found no diminution in myometrial flow, cardiac Output increases during pregnancy [12]. but a reduction in placental flow, The reason for The difference in values might depend on the this discrepancy is not apparent.…”

Section: The Microspheresmentioning

confidence: 86%

“…The values were error of the mean (SEM) were calculated. Com-obtained after the animals had been breathing parisons were carried out with the help of Group either 30 per cent or [10][11][12][13][14][15] None of the animals showed any change of blood pressure during the injection of microspheres. Some of the rabbits had a slight depression of heart frequency, but it was restored in a few seconds.…”

Section: The Microspheresmentioning

confidence: 99%

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The influence of hypoxia on uterine and maternal placental blood flow, and the effect of α-adrenergic blockade

Karlsson¹

1974

Journal of Perinatal Medicine

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The peripheral blood flow in all species is widely to the placenta was reduced from about 60 to redistributed during hypoxia. Dependent upon about 32 per cent during hypoxia. the species and the respiratoryresponsealowering In a study using the macroaggregate distribution of the arterial P Oa gives an increase in c rdiac technique POWER et al. [ISjfoundthatthedistribuoutput and in heart f requency, or a decrease in the tion in the placenta became more uniform, when same parameters [11]. The general pattern of the animal was hypoxic, giving a less variable response is a reduction of blood flow to most local relation between the maternal and fetal flow. organs, but preservation or even an increase of This indicates a placental vasodilatation. blood flow to vital organs -the brain and the The present experiments were performed to myocardium. In pregnancy a special Situation is investigate whether hypoxic vasoconstriction established since the placenta is a non-vital organ takes place in the uterus-placental circulation in for the mother but a vital organ for the fetus. the pregnant rabbit, and if so, what the mechanism The question arises, whether the Uterus-for vasoconstriction might be. placenta circuit will take part in the general peripheral vasoconstriction during maternal . _,, . . Έ ^, , ϊ . * i^ t ui j Λ ·ιι t-* Material and Methods hypoxia, or whether the blood flow will be preserved.The material consisted of 14 pregnant rabbits Great difficulties have earlier been encountered with dated gestations from 25 to 30 days. The when studying the uterine circulation. The posi-pregnant term for rabbits is 31 ± 2 days. The tion of the organ, with several vessels both on the mean body weight was 4.39 kg i 0.16 (SD). inflow and outflow side, has complicated the study Anesthesia was induced with pentothal (25 mg/ of circulation of this special organ. Information on kg) through a catheter in a lateral ear-vein, and the uterine circulation in pregnancy during hypo-maintained with additional small amounts of xia is conflicting. Thus ASSALI et al.[2] found a pentothal. The rabbit was placed on a warm table progressive increase in blood flow to the Uterus and the trachea cannulated. The animal was in pregnant ewes, when these were breathing artificially ventilated with known gas mixtures 10 per cent oxygen, while DUNCAN et al.[5] using a small animal Ideal Pump (volume/ found a reduction in the total uterine blood flow, f requency = 22 ml/36 rpm). probably because of local vasoconstriction during Arterial blood pressure and heart frequency were hypoxia. The latter authors performed their in-registered through a catheter in the right brachial vestigations on rabbits with the microsphere artery. The Signals were monitored by a STATHAM technique and found, apart from the reduction P 23 AC transducer, atnplified and recorded on a of uterine blood flow, a redistribution of the total GRASS model 7 polygraph. Samples for blood flow within the organ, so that the fraction going gas determinations were taken through the same

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Section: The Microspheresmentioning

confidence: 86%

Section: The Microspheresmentioning

confidence: 99%

The influence of hypoxia on uterine and maternal placental blood flow, and the effect of α-adrenergic blockade

Karlsson¹

1974

Journal of Perinatal Medicine

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“…increases by 30%-40%, 13,14 and there is an eightfold increase in uterine artery blood flow. 15 Blood pressure (BP) decreases until around week 18 of pregnancy and progressively increases toward term.…”

Section: Introductionmentioning

confidence: 98%

Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Enkhmaa

Wall

Mehta

et al. 2016

Journal of Women's Health

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Preeclampsia affects *3%-7% of all pregnancies and is the third leading cause of maternal mortality globally. Growing evidence indicates that preeclampsia results from vascular dysfunction, which also increases the risk for future cardiovascular events. Until recently, preeclampsia was considered a disorder limited to pregnancy, which fully resolved with the delivery of the placenta; however, it is now clear that women with a history of preeclampsia have approximately double the risk of future cardiovascular events compared to women with normotensive pregnancies. The aims of this review were to describe the hemodynamic and vascular changes that occur in normal and preeclamptic pregnancies, to review noninvasive methods to test vascular function, and to discuss the associated increased cardiovascular disease risk related to preeclampsia.

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“…9,10 Pregnancy produces changes in the cardiovascular system that have profound implications for cardiac surgery. Cardiac output increases markedly by the end of the 1st trimester, and this is followed by a more gradual increase to 30% to 40% above baseline by the 3rd trimester, 12,13 partly due to an increase in stroke volume and heart rate. In most patients, this hyperdynamic situation results in a soft midsystolic murmur.…”

Section: Maternal Cardiovascular Changes During Pregnancymentioning

confidence: 99%

Cardiac surgery during pregnancy

Conolly¹,

Khan²

2012

Core Topics in Cardiac Anesthesia

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A pproximately 2% to 4% of women of childbearing age have concomitant heart disease.1 In the Western world, congenital heart disease (CHD) accounts for most of the structural heart disease that affects women of childbearing age.2 Acquired cardiac disease seen during pregnancy is mainly valvular in nature, usually a consequence of rheumatic fever.2 Even though rheumatic fever is decreasing in developed countries, it continues to be a serious problem in the developing world. Immigrants also form a high-risk population, especially those who are unaware of the inherent risks of heart disease during pregnancy or are even unaware of the presence of any cardiac disease. Mitral stenosis is the most common lesion encountered, 2 although its incidence is on the decline. Aortic valve disease is less common: aortic incompetence is usually a consequence of endocarditis (1 in 8,000 pregnancies) or aortic dissection, in which case there may be an underlying connective tissue disorder such as Marfan syndrome. Significant aortic stenosis is uncommon in this age group.3 Ischemic events during pregnancy are rare. The incidence of myocardial infarction is approximately 1 in 10,000 pregnancies. 4,5 Infarction is usually secondary to underlying coronary artery disease, although spontaneous coronary artery dissection seems to be more common during pregnancy and accounts for 30% of all myocardial infarctions seen in pregnancy. 6,7 Predictors of Maternal and Fetal OutcomeIn the United Kingdom, cardiac disease in the mother is the major cause of maternal death during pregnancy. Of these patients, 25% have CHD. 8 In a large, prospective multicenter study of pregnancy outcomes among women with heart disease, adverse maternal cardiovascular events were seen in 13% of patients. Independent predictors of maternal cardiac complications included prior cardiac events, New York Heart Association functional class III/IV or cyanosis, left-heart obstruction, and left ventricular systolic dysfunction (Table I). Neonatal complications were seen in 20% and were associated with poor functional class or cyanosis, left-heart obstruction, or smoking. 9A recent prospective observational study in pregnant patients with CHD found that both cardiac complication and neonatal complication rates were considerable in these women. In mothers, right subpulmonary ventricular systolic dysfunction and severe pulmonary regurgitation were predictors of an adverse fetal outcome. 10 In a recently published literature review that described the outcomes of 2,491 pregnancies among women with structural CHD, substantial cardiac complications were seen in 11% of the pregnancies. Obstetric complications did not appear to be more prevalent,

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A Study of Cardiac Output at Rest Throughout Pregnancy

Cited by 181 publications

References 24 publications

The influence of hypoxia on uterine and maternal placental blood flow, and the effect of α-adrenergic blockade

The influence of hypoxia on uterine and maternal placental blood flow, and the effect of α-adrenergic blockade

Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Cardiac surgery during pregnancy

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