Cardiovascular Function Before, During, and After the First and Subsequent Pregnancies

Clapp, James F.; Capeless, Eleanor L.

doi:10.1016/s0002-9149(97)00738-8

Cited by 441 publications

(299 citation statements)

References 23 publications

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“…The volume-overloaded state (with increased preload) of pregnancy causes physiological LVH;17 after the first pregnancy, subsequent pregnancies have been shown to enhance this 16. Similarly, as mentioned, the expected pregnancy-associated ST-segment sagging depressed the ‘Negroid pattern’ ST-segment elevation to the isoelectric line.…”

Section: Discussionmentioning

confidence: 90%

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Akinwusi¹,

Oboro²,

Adebayo³

et al. 2011

CardioVascular Journal of Africa

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IntroductionPregnancy is associated with major haemodynamic and cardiac changes, which can mimic or precipitate cardiac diseases. There is a paucity of this kind of data among pregnant Nigerian women. This study was aimed at describing the cardiovascular and electrocardiographic changes found among healthy pregnant Nigerian women.MethodsThis was an age-matched control study of 69 consecutive normal pregnant and 70 healthy non-pregnant controls. The study protocol included history, physical examination and 12-lead electrocardiography.ResultsDiastolic blood pressure < 60 mmHg was significantly commoner among pregnant subjects than controls (64.7 vs 24.3%, respectively, p < 0.005). Mean heart rate was higher among pregnant women (88.34 ± 11.46 bpm) than the controls (75.16 ± 12.22 bpm, p = 0.020). Pregnant subjects also had a higher proportion of left ventricular hypertrophy (LVH) (10.2 vs 0%, p < 0.05) than non-pregnant controls. Abnormal cardiac findings included a loud second heart sound (P2), missed beats and systolic murmurs (41.2% in pregnant subjects vs 12.9% in non-pregnant controls, p < 0.05). Negroid-pattern ST-segment elevation was commoner among controls (24.3%) than pregnant subjects (2.9%, p < 0.005). Arrhythmias were rare among the study participants.ConclusionSignificant findings on examination were low diastolic blood pressure and a systolic ejection murmur. However, ECG changes showed a normal frontal-plane QRS axis, normal PR interval, significantly rare normal Negroidpattern ST elevation, significant LVH based on Araoye RI > 12 mm and a rarity of all forms of arrhythmias. These data may help resolve some cardiac diagnostic difficulties during pregnancy.

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Section: Discussionmentioning

confidence: 90%

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Akinwusi¹,

Oboro²,

Adebayo³

et al. 2011

CardioVascular Journal of Africa

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“…Alternatively, pregnancy is associated with positive cardiovascular adaptations such as increased stroke volume (SV), heart rate (HR), and cardiac output (Q) and decreased total peripheral resistance (TPR) designed to promote the convective delivery of oxygen and nutrients to the developing fetus (7,11). As part of this adaptation, muscular (brachial) artery stiffness, as measured by carotid-radial pulse wave velocity (PWV), is decreased with pregnancy (28,39).…”

mentioning

confidence: 99%

Influence of hyperglycemia during and after pregnancy on postpartum vascular function

Davenport

Goswami

Shoemaker

et al. 2012

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Approximately 500 mL of blood is lost at the time of vaginal delivery, and approximately 1 000 mL during a normal caesarean delivery. (20,21) Normally, the hemodynamic changes that occur during pregnancy are well tolerated by the mother. However, CHD may be initially identifi ed during pregnancy because of increased cardiac output or because minor preexisting symptoms may be exacerbated.…”

Section: Physiologic Hemodynamic Changes During Pregnancy Delivery Amentioning

confidence: 99%

Pregnancy, Genetic Risk and Congenital Heart Disease

Jost

Connolly

2017

SAHJ

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An increasing number of women with congenital heart disease (CHD) are reaching childbearing age and are considering pregnancy. Pregnancy is tolerated well in most of these women with unoperated, or repaired cardiac lesions; however, the risk is increased considerably in certain situations such as pulmonary hypertension, severe valvular stenosis, pulmonary atresia, mechanical prosthetic valves, with Fontan type circulation, in Marfan syndrome and other aortopathy. Counseling prior to pregnancy in CHD also involves discussion of genetic testing, possibility of transmission to the child, management during pregnancy including preimplantation genetic testing, and recommendations regarding fetal echocardiography. All medications including anticoagulation options if needed should be carefully reviewed prior to pregnancy due to maternal and fetal risks. If needed, cardiac surgery or balloon valvuloplasty can be carried out with an increased risk to mother and fetus. Overall, pregnancy in CHD is feasible in most patients with good maternal and fetal outcome. High risk pregnancy patients with CHD have to be counseled by a multidisciplinary team including cardiologists, obstetricians and anesthesiologists at a tertiary care center. ABSTRACT PREGNANCY AND CONGENITAL HEART DISEASE

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Cardiovascular Function Before, During, and After the First and Subsequent Pregnancies

Cited by 441 publications

References 23 publications

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Influence of hyperglycemia during and after pregnancy on postpartum vascular function

Pregnancy, Genetic Risk and Congenital Heart Disease

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