Vascular Reactivity in Normal Pregnancy and in Pregnancies Complicated by Hypertension

Castrén, Olli; Saarikoski, Seppo; Siimes, Anja

doi:10.1002/j.1879-3479.1973.tb00908.x

Cited by 14 publications

(5 citation statements)

References 14 publications

(14 reference statements)

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“…Perhaps more importantly is a reduction in the reflex autonomic responses leading to compensatory tachycardia and vasoconstriction (7, 11). The heart rate responses also tend to be reduced during an orthostatic challenge (11, 30, 31), however, other studies suggest that the heart rate response can be unchanged or somewhat enhanced (6, 9, 10, 32). So the responses appear to be variable in healthy women.…”

Section: Discussionmentioning

confidence: 99%

“…and may create a further risk for the patient. Hemodynamic changes accompanying pregnancy include an impairment of neural control of blood pressure as evidenced by reduced pressor responses to Valsalva’s maneuver and exercise (6, 21-24). The changes in heart rate variability suggest that pregnancy is accompanied by a generalized blunting of vagal control as evidenced by reduced time-domain measures reduced high frequency power of the power spectrum of heart rate (22, 25, 26).…”

Section: Discussionmentioning

confidence: 99%

“…Limited literature suggests that hemodynamic control does change throughout the course of pregnancy (6-11). The control of blood pressure in the third trimester appears to be somewhat impaired in many women as evidenced by a greater tendency for hypotension during a Valsalva maneuver after epidural block of the sympathetic-mediated vasoconstrictor responses (6). The hemodynamic response to standing has been studied more extensively (7-11).…”

Section: Introductionmentioning

confidence: 99%

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Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy

Hensel¹,

Pacchia²,

Smith³

2013

Complementary Therapies in Medicine

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Objectives The physiological changes that occur during pregnancy, including increased blood volume and cardiac output, can affect hemodynamic control, most profoundly with positional changes that affect venous return to the heart. By using Osteopathic Manipulative Treatment (OMT), a body-based modality theorized to affect somatic structures related to nervous and circulatory systems, we hypothesized that OMT acutely improves both autonomic and hemodynamic control during head-up tilt and heel raise in women at 30 weeks gestation. Design One hundred subjects were recruited at 30 weeks gestation. Setting The obstetric clinics of UNTHealth in Fort Worth, Texas. Intervention Subjects were randomized into one of three treatment groups: OMT, placebo ultrasound, or time control. Ninety subjects had complete data (N=25, 31 and 34 in each group respectively). Main outcome measures Blood pressure and heart rate were recorded during 5 min of head-up tilt followed by 4 min of intermittent heel raising. Results No significant differences in blood pressure, heart rate or heart rate variability were observed between groups with tilt before or after treatment (p>0.36), and heart rate variability was not different between treatment groups (p>0.55). However, blood pressure increased significantly (p=0.02) and heart rate decreased (p<0.01) during heel raise after OMT compared to placebo or time control. Conclusions These data suggest that OMT can acutely improve hemodynamic control during engagement of the skeletal muscle pump and this was most likely due to improvement of structural restrictions to venous return.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy

Hensel¹,

Pacchia²,

Smith³

2013

Complementary Therapies in Medicine

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“…[20][21][22][23] On the contrary, many animal studies 24,25 showed pregnancy to be associated with an impaired baroreflex sensitivity, and an attenuated ability to increase sympathetic outflow above baseline levels during a hypotensive challenge.…”

Section: Discussionmentioning

confidence: 99%

Baroreflex control of heart rate is impaired in pre-eclampsia

et al. 1999

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Autonomic nervous dysfunction, such as parasympathetic and sympathetic impairment, has been suggested as possible cause of pre-eclampsia, but the studies are not conclusive. Our purpose was to assess non-invasively if pre-eclampsia is associated with a decreased baroreflex function. Nine women with pre-eclampsia (PE), eight normotensive pregnant women, and seven healthy normotensive non-pregnant women were studied. Continuous finger blood pressure was recorded by a Portapres device in the left lateral recumbent position and active standing. Baroreflex gain was evaluated by

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“…The sym pathetic tonus may be increased in toxaemia [1][2][3], Ve nous plasma adrenaline is elevated in toxacmic patients when compared to normotensive pregnant women, but there is no difference in venous plasma noradrenaline between both groups [4],…”

Section: Introductionmentioning

confidence: 99%

Catecholamine Concentrations in Venous Plasma and Cerebrospinal Fluid in Normal and Complicated Pregnancy

Tinkanen

Rorarius

Metsä‐Ketelä

1993

Gynecol Obstet Invest

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The concentrations of adrenaline and noradrenahne were determined in venous plasma and cerebrospinal fluid (CSF) of 41 pregnant women at term scheduled for elective or ‘hot’ caesarean section and in 7 healthy non-pregnant women scheduled for elective surgery. Group 1:10 pregnant women at term with a normal history of their pregnancy; group 2: like group 1 but in active labour for more than 4 h; group 3: 10 pregnant women with insulin-dependent diabetes mellitus with or without slightly elevated arterial blood pressure; group 4: 11 women with pre-eclampsia gravis; group 5: 7 healthy non-pregnant women of fertile age. The highest values of mean arterial blood pressure and of venous plasma noradrenahne were found in the pre-eclamptic group 4, mean arterial blood pressure and plasma noradrenahne levels correlated to each other. However, concentrations of noradrenahne in CSF in group 4 did not differ significantly from the other groups. It is speculated that a different origin of hypertension may be the reason for the normal noradrenahne concentrations in CSF. This finding is in contrast to earlier findings in which noradrenahne levels in CSF were elevated in patients with essential hypertension.

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Vascular Reactivity in Normal Pregnancy and in Pregnancies Complicated by Hypertension

Cited by 14 publications

References 14 publications

Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy

Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy

Baroreflex control of heart rate is impaired in pre-eclampsia

Catecholamine Concentrations in Venous Plasma and Cerebrospinal Fluid in Normal and Complicated Pregnancy

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