Alterations in Cardiovascular Physiology During Labor

Adams, John; Alexander, A.

doi:10.1097/00132586-196004010-00007

Cited by 8 publications

(24 citation statements)

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“…Comparison of this data with the results of a cardiovascular follow-up of healthy women without heart ailments shows the latter did not develop cardiac arrhythmias during labor, although blood pressure rose and cardiac output increased by about 31% during uterine contractions (20). Other authors have found increased cardiac output, rising blood pressure, and, in contrast to quadriplegic patients, accelerated pulse in healthy women (1,17,23). Similar adrenergic crises may be seen in pheochromocytoma (34).…”

Section: Deliverymentioning

confidence: 91%

Sexual Function, Pregnancy and Delivery in Spinal Cord Injured Women

Ohry¹,

Peleg²,

Goldman³

et al. 1978

Gynecol Obstet Invest

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Complete spinal cord injury results in abolition of motor, sensory and autonomic functions. Among the autonomic functions, the sexual system is seriously disturbed. The spinal cord injury with its many complications offers a challenge to the rehabilitation team, and the sexual problem is one of its most important aspects. For the female paraplegic, rehabilitation of sexual functions is an essential part in the building of a positive new self-image. In this review, we try to summarize the gynecological and obstetrical aspects of spinal cord injured women. Although the innervation of the reproductive system is damaged, this system continues to function and the menstrual cycle resumes its normal course after a while. Ovulation takes place regularly and pregnancy is possible. Today the general opinion is that the pregnant paralyzed woman can deliver vaginally and not by cesarean section as was believed before. We emphasize the importance of special medical care before, during and after delivery. The cooperation between physiatrist and gynecologist is mandatory.

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Section: Deliverymentioning

confidence: 91%

Sexual Function, Pregnancy and Delivery in Spinal Cord Injured Women

Ohry¹,

Peleg²,

Goldman³

et al. 1978

Gynecol Obstet Invest

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“…e54 venous return increases maternal cardiac output by 60% to 80% after vaginal delivery. [58][59][60][61][62]65 This abrupt rise in cardiac output dissipates to prelabor values within ≈1 hour postpartum and falls further over the following 24 weeks. Mean arterial pressure can be elevated for 1 to 2 days postpartum 60 before declining over the ensuing 2 weeks.…”

Section: Postpartummentioning

confidence: 99%

“…[59][60][61] A change from the supine to a lateral recumbent position between contractions (basal conditions) increases maternal cardiac output by ≈22% and decreases heart rate by 6%. 60 Basal systemic arterial pressure rises with the progression of the first stage of labor, with further increases during uterine contractions.…”

Section: Intrapartummentioning

confidence: 99%

“…60 Basal systemic arterial pressure rises with the progression of the first stage of labor, with further increases during uterine contractions. 33,59,61 Uterine contractions augment maternal cardiac output as a result of enhanced sympathetic activity (via anxiety, pain) and expulsion of uterine blood into the central venous circulation. [58][59][60] During a contraction, the uterus expels up to 400 mL blood into the central venous circulation, leading to a rise in central venous pressure, right atrial pressure, 62 cardiac output, and arterial pressure.…”

Section: Intrapartummentioning

confidence: 99%

“…These changes begin to reverse shortly after delivery and continue to decrease over the next 24 hours, resolving over the next 6 to 8 weeks. [59][60][61]120,121 The extravascular fluid accumulation that occurs during gestation will typically resolve over a similar time interval.…”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

See 2 more Smart Citations

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Canobbio¹,

Warnes²,

Aboulhosn³

et al. 2017

Circulation

320

303

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Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management.

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Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women’s Health Initiative

Hall

Nah

Howard

et al. 2017

Journal of the American College of Cardiology

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BACKGROUND Reproductive factors reflective of endogenous sex hormone exposure might have an effect on cardiac remodeling and the development of heart failure (HF). OBJECTIVES This study examined the association between key reproductive factors and the incidence of HF. METHODS Women from a cohort of the Women’s Health Initiative were systematically evaluated for the incidence of HF hospitalization from study enrollment through 2014. Reproductive factors (number of live births, age at first pregnancy, and total reproductive duration [time from menarche to menopause]) were self-reported at study baseline in 1993 to 1998. We employed Cox proportional hazards regression analysis in age- and multivariable-adjusted models. RESULTS Among 28,516 women, with an average age of 62.7 ± 7.1 years at baseline, 1,494 (5.2%) had an adjudicated incident HF hospitalization during an average follow-up of 13.1 years. After adjusting for covariates, total reproductive duration in years was inversely associated with incident HF: hazard ratios (HRs) of 0.99 per year (95% confidence interval [CI]: 0.98 to 0.99 per year) and 0.95 per 5 years (95% CI: 0.91 to 0.99 per 5 years). Conversely, early age at first pregnancy and nulliparity were significantly associated with incident HF in age-adjusted models, but not after multivariable adjustment. Notably, nulliparity was associated with incident HF with preserved ejection fraction in the fully adjusted model (HR: 2.75; 95% CI: 1.16 to 6.52). CONCLUSIONS In postmenopausal women, shorter total reproductive duration was associated with higher risk of incident HF, and nulliparity was associated with higher risk for incident HF with preserved ejection fraction. Whether exposure to endogenous sex hormones underlies this relationship should be investigated in future studies.

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Alterations in Cardiovascular Physiology During Labor

Cited by 8 publications

References 0 publications

Sexual Function, Pregnancy and Delivery in Spinal Cord Injured Women

Sexual Function, Pregnancy and Delivery in Spinal Cord Injured Women

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Reproductive Factors and Incidence of Heart Failure Hospitalization in the Women’s Health Initiative

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