Acid-base regulation in pregnancy

Vs, Lim; Katz, Amos; Lindheimer,

doi:10.1152/ajplegacy.1976.231.6.1764

Cited by 81 publications

(22 citation statements)

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“…During pregnancy, the female body undergoes a series of physiological changes, slowly occurring over a 9-month period, which indeed alter metabolic, endocrine, respiratory and hemodynamic response [1,20,21] . The pregnant uterus mechanically compresses abdominal vessels, reducing blood return to the heart from the lower part of the body.…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study

Arbeid¹,

Demi²,

Brogi

et al. 2016

Gynecol Obstet Invest

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Background/Aims: The normal lung ultrasound (US) pattern during a regular pregnancy has not been evaluated extensively in the current literature. Pregnancy-related changes in the respiratory tract affect maternal predisposition to several respiratory complications; consequently, it is important to differentiate between a physiologic pattern during pregnancy and a pathologic lung pattern, due to respiratory failure. The goal of our study was to assess the normal US lung pattern in women without known comorbidities in the last weeks of pregnancy. Methods: We conducted a prospective cross-sectional observational pilot study. Chest wall was examined in 8 areas, 1 scan for each area with women in supine position. Results: One hundred fifty parturients were enrolled during the 36th-38th gestational weeks. None of the participants showed pleural effusion, pneumothorax or lung consolidation. None presented an interstitial syndrome US pattern. One hundred thirteen participants out of 150 (75%) showed A-lines in all the regions. The remaining 25% showed 1 or 2 B-lines in at least 3 regions. Only 2 participants showed 2 positive regions also. Conclusions: We found that, in the majority of the women examined, the lung US pattern matches the physiological pattern in non-pregnant patients. Lung US assessment is a feasible and a helpful diagnostic tool during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study

Arbeid¹,

Demi²,

Brogi

et al. 2016

Gynecol Obstet Invest

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“…Similarly, increasing the water intake of nonpregnant rats to values twice those measured during gestation for 19 consecutive d had no effect on their Posm or their threshold for AVP secretion. Pregnant women hyperventilate and Pco2 and PHCO3 decrease -10 mm Hg and 4 meq/liter, respectively (26,27).…”

Section: Brattleboro Rats With Hereditary Diabetes Insipidusmentioning

confidence: 99%

Osmoregulation during Pregnancy in the Rat

Dürr¹,

Stamoutsos²,

Lindheimer³

1981

J. Clin. Invest.

125

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AB S T R A C T Osmoregulation was studied in near term and age-matched Sprague-Dawley rats. Basal plasma osmolality (Posm) and plasma sodium (PNa) were 281+3 mosmol/kg and 134+3 meq/liter, respectively, on the 20th gestational day compared with 292+±3 mosmol/kg and 140+1 meq/liter in virgin animals (P < 0.001), whereas Purea and plasma water content were similar in pregnant and control rats. These differences could not be reproduced in animals receiving progesterone, estrone, or a combination of progesterone and estradiol for 2 wk.Pregnant and control rats were deprived of water for changes (A%) were significantly greater in the gravid animals (P < 0.01). Therefore, Posm was increased without concomitant volume depletion by intraperitoneal hypertonic saline. Again PAVP VS. Posm correlated significantly (r > 0.9; P < 0.001) in each group, and the apparent threshold was 14 mosmol lower in pregnant animals. Diluting ability, tested by oral water loading, was not impaired in the pregnant animals which excreted a 30 ml/kg load as well as controls. Also, chronically hydrated virgin animals whose fluid intake was more than twice that of pregnant rats (for 19 d) did not lower their Posm.In separate studies homozygous Brattleboro rats, which produce no endogenous vasopressin, were also shown to have a decreased Posm (pregnant 292 +4 mosmol/kg; virgin 310+6 mosmol/kg P < 0.001), but unchanged Uosm during pregnancy.Data demonstrate a resetting ofthe osmostat in gravid Sprague-Dawley rats as Posm and the threshold for AVP secretion both decrease significantly during gestation in this species. Studies in homozygous Brattleboro animals with hereditary diabetes insipidus suggest that the osmotic threshold for thirst is reset as well. INTRODUCTION Plasma osmolality decreases during normal human pregnancy to values that range 5-10 mosmol/kg below that of nonpregnant women (1-3). This decrement is apparent by the 6th gestational wk and is sustained until term. If such a reduction in osmolality occurred in a nongravid subject she would cease secreting antidiuretic hormone (ADH)l and enter a state of con-

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“…Pregnant women suffer from chronic respiratory alkalosis due to increase in minute ventilation. This hypocapnia results from direct stimulation of respiratory center by progesterone (Lim et al, 1976). Partial pressure of carbon dioxide (pCO2) decreases to 27-32 mm.Hg and is accompanied by compensatory increase in renal excretion of bicarbonate.…”

Section: Renal Physiology In Pregnancymentioning

confidence: 99%

Gynaecologic Nephrology

R.¹

2012

American Medical Journal

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Renal issues are commonly encountered in females. They can occur both in pregnant and nonpregnant females. Many physiologic changes occur during pregnancy to accommodate the growing fetus. Pregnancy is characterized by changes in blood pressure and expansion of total body volume which results in high glomerular filtration rate. The common renal problems seen in pregnant females are hypertension, proteinuria with or without nephrotic syndrome, acute kidney injury. It is not uncommon to see a pregnant female who may have pre-existing chronic kidney disease. A very few women receiving dialysis become pregnant. Renal transplantation restores the infertility seen in chronic kidney disease. Renal transplant recipients with pregnancy require very close monitoring of immunosuppressive medications to prevent acute rejection due to altered drug absorption and metabolism in pregnancy. Uterine fibroids are commonly encounters in women of reproductive age. Nonpregnant females with uterine fibroids usually experience non-renal symptoms like excessive uterine bleeding but few of them can develop hypertension, acute kidney injury and chronic kidney disease from uterine fibroids. Malignancies of female genital system can give rise to kidney failure when locally invasive. This review paper gives details of various renal problems seen by nephrologists in female patients both during pregnancy and nonpregnant states in daily practice.

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Acid-base regulation in pregnancy

Cited by 81 publications

References 0 publications

Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study

Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study

Osmoregulation during Pregnancy in the Rat

Gynaecologic Nephrology

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