Advertisement
Research Article| Volume 7, ISSUE 4, P763-775, October 1991

Cardiorespiratory Alterations During Normal Pregnancy

  • Wesley Lee
    Correspondence
    Address reprint requests to: Wesley Lee, MD, Department of Obstetrics and Gynecology, William Reaumont Hospital, 3601 West Thirteen Mile Road, Royal Oak, MI 48072
    Affiliations
    Faculty Staff, Department of Obstetrics and Gynecology, William Beaumont Hospital, Royal Oak, Michigan
    Search for articles by this author
DOI:https://doi.org/10.1016/S0749-0704(18)30279-3
Cardiorespiratory Alterations During Normal Pregnancy
Previous ArticlePreface
Next ArticleCardiac Disease in Pregnancy
      This paper is only available as a PDF. To read, Please Download here.
      Several physiologic changes can influence the maternal cardiovascular and respiratory systems. A clear understanding of these alterations is necessary as the basis of good clinical care for normal gravidas and critically ill women who happen to be pregnant.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Critical Care Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Adams J.Q.
        • Alexander A.M.
        Alterations in cardiovascular physiology during labor.
        Obstet Gynecol. 1958; 12: 542
        • Anderson G.J.
        • James G.B.
        • Mathers N.P.
        • et al.
        The maternal oxygen tension and acid-base status during pregnancy.
        Journal of Obstetrics and Gynaecology of the British Commonwealth. 1969; 76: 16
        • Assali N.S.
        • Rauamo L.
        • Peltonen T.
        Measurement of uterine blood flow and uterine metabolism: VII. Uterine and fetal blood flow and oxygen consumption in early human pregnancy.
        Am J Obstet Gynecol. 1960; 79: 86
        • Atkins A.F.J.
        • Watt J.M.
        • Milan P.
        • et al.
        A longitudinal study of cardiovascular dynamics throughout pregnancy.
        Eur J Obstet Gynaecol Reprod Biol. 1981; 12: 215
        • Atkins A.F.J.
        • Watt J.M.
        • Milan P.
        • et al.
        The influence of posture upon cardiovascular dynamics throughout pregnancy.
        Eur J Obstet Gynaecol Reprod Biol. 1981; 12: 215
        • Awe R.J.
        • Nicotra M.B.
        • Newsom T.D.
        • et al.
        Arterial oxygenation and alveolar-arterial gradients in term pregnancy.
        Obstet Gynecol. 1979; 53: 182
        • Bader R.A.
        • Bader M.G.
        • Rose D.J.
        • et al.
        Hemodynamics at rest and during exercise in normal pregnancy as studied by cardiac catheterization.
        J Clin Invest. 1955; 34: 1524
        • Bieniarz J.
        • Maqueda E.
        • Caldyro-Barcia R.
        Compression of aorta by the uterus in late human pregnancy. I. Variations between femoral and brachial artery pressure with changes from hypertension to hypotension.
        Am J Obstet Gynecol. 1966; 95: 795
        • Bieniarz J.
        • Crottogini J.J.
        • Curuchet E.
        • et al.
        Aortocaval compression by the uterus in late human pregnancy. II. An arteriographic study.
        Am J Obstet Gynecol. 1968; 100: 203
        • Burwell C.S.
        • Strayhorn W.D.
        • Flickinger D.
        • et al.
        Circulation during pregnancy.
        Arch Intern Med. 1938; 62: 979
        • Burwell C.S.
        The influence of pregnancy on the course of heart disease.
        South Med J. 1936; 29: 1194
        • Capeless E.L.
        • Clapp I.F.
        Cardiovascular changes in early phase of pregnancy.
        Am I Obstet Gynecol. 1989; 161: 1449
        • Caton W.L.
        • Roby C.C.
        • Reid D.E.
        • et al.
        The circulating red cell volume and body hematocrit in normal pregnancy and the puerperium.
        Am J Obstet Gynecol. 1951; 61: 1207
        • Chesley L.C.
        Renal functional changes in normal pregnancy.
        Clin Obstet Gynecol. 1960; 3: 349
        • Clark S.L.
        • Cotton D.B.
        • Lee W.
        • et al.
        Central hemodynamic assessment of normal term pregnancy.
        Am J Obstet Gynecol. 1989; 161: 1439
        • Cugell D.W.
        • Frank N.R.
        • Gaensler E.A.
        • et al.
        Pulmonary function in pregnancy: I. Serial observations in normal women.
        American Review of Tuberculosis. 1953; 67: 568
        • Easterling T.R.
        • Watts D.H.
        • Schmucker B.C.
        • et al.
        Measurement of cardiac output during pregnancy: Validation of Doppler technique and clinical observations in preeclampsia.
        Obstet Gynecol. 1987; 69: 845
        • Gerber J.G.
        • Payne H.A.
        • Murphy R.C.
        • et al.
        Prostacyclin produced by the pregnant uterus in the dog may act as a circulating vasodepressor substance.
        J Clin Invest. 1981; 67: 632
        • Ginsberg J.
        • Duncan S.L.
        Direct and indirect blood pressure measurement in pregnancy.
        Journal of Obstetrics and Gynaecology of the British Commonwealth. 1969; 76: 705
        • Greiss F.C.
        • Anderson S.G.
        Effect of ovarian hormones on the uterine vascular bed.
        Am J Obstet Gynecol. 1970; 107: 829
        • Hamilton H.F.H.
        The cardiac output in normal pregnancy as determined by the Cournard right heart catheterization technique: Journal of Obstetrics and Gynaecology of the British Empire.
        . 1949; 56: 548
        • Harada A.
        • Hershman J.M.
        • Reed A.W.
        • et al.
        Comparison of thyroid stimulators and thyroid hormone concentrations in the sera of pregnant women.
        J Clin Endocrinol Metab. 1979; 48: 793
        • Heilmann L.
        Blood rheology and pregnancy.
        Baiilieres Clinical Haematology. 1987; 1: 777
        • Hendricks C.H.
        • Quilligan E.J.
        Cardiac output during labor.
        Am J Obstet Gynecol. 1958; 76: 969
        • Holmes F.
        Incidence of the supine hypotensive syndrome in late pregnancy.
        Journal of Obstetrics and Gynaecology of the British Empire. 1960; 67: 254
        • James C.F.
        • Banner T.
        • Caton D.
        Cardiac output in women undergoing cesarean section with epidural or general anesthesia.
        Am J Obstet Gynecol. 1989; 160: 1178
        • Jepson J.H.
        Endocrinologic control of maternal and fetal erythropoeisis.
        Can Med Assoc J. 1968; 98: 844
        • Katz R.
        • Karliner J.S.
        • Resnik R.
        Effects of a natural volume overload state (pregnancy) on left ventricular performance in normal human subjects.
        Circulation. 1978; 58: 434
        • Kirshon B.
        • Lee W.
        • Cotton D.B.
        • et al.
        Indirect blood pressure monitoring in the obstetric patient.
        Obstet Gynecol. 1987; 70: 799
        • Kjeldsen J.
        Hemodynamic investigations during labor and delivery.
        Acta Obstet Gynecol Scand [Suppl]. 1979; 89: 1
        • Koller O.
        The clinical significance of hemodilution during pregnancy.
        Obstet Gynecol Surv. 1982; 37: 649
        • Laird-Meeter K.
        • van de Ley G.
        • Bom T.H.
        • et al.
        Cardiocirculatory adjustments during pregnancy—an echocardiographic study.
        Clin Cardiol. 1979; 2: 328
        • Lee W.
        • Rokey R.
        • Cotton D.B.
        • et al.
        Maternal hemodynamic effects of uterine contractions by M-mode and pulsed-Doppler echocardiography.
        Am J Obstet Gynecol. 1989; 161: 974
        • Lee W.
        • Rokey R.
        • Cotton D.B.
        Noninvasive maternal stroke volume and cardiac output determinations by pulsed Doppler echocardiography.
        Am J. Obset Gynecol. 1988; 158: 505
        • Lees M.M.
        • Taylor S.H.
        • Scott D.B.
        • et al.
        A study of cardiac output at rest throughout pregnancy.
        Journal of Cbstecricc and Gynaecology of llie British Common we31 th. 1967; 74: 319
        • Longo L.D.
        • Hardesty J.S.
        Maternal blood volume: Measurement, hypothesis of control, and clinical considerations.
        Piev Perinatal Med. 1984; 5: 35
        • Lund C.J.
        • Donovan J.C.
        Blood volume during pregnancy.
        Am J Obstet Gynecol. 1967; 98: 393
        • MacGillivray I.
        • Rose G.A.
        • Rowe B.
        Blood pressure survey in pregnancy.
        Clin Sci. 1969; 37: 395
        • Mashini I.S.
        • Albazzaz S.
        • Fadel H.E.
        • et al.
        Serial noninvasive evaluation of cardiovascular hemodynamics during pregnancy.
        Am J Obstet Gynecol. 1987; 156: 1208
        • McLennon C.E.
        • Thouin L.G.
        Blood volume in pregnancy.
        Am J Obstet Gynecol. 1948; 55: 1189
        • Metcalfe J.
        • Romney S.L.
        • Ramsy L.H.
        • et al.
        Estimation of uterine blood flow in normal human pregnancy at term.
        J Clin Invest. 1955; 34: 1632
        • Morton M.
        • Tsang H.
        • Hohimer R.
        • et al.
        Left ventricular size, output, and structure during guinea pig pregnancy.
        Am J Physiol. 1984; 46: R40
        • Moutquin J.M.
        • Rainville R.N.
        • Girouv L.
        • et al.
        A prospective study of blood pressure in pregnancy: Prediction of preeclampsia.
        Am J Obstet Gynecol. 1985; 151: 191
        • Page E.W.
        • Christianson R.
        The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy.
        Am J Obstet Gynecol. 1976; 125: 740
        • Palmer A.J.
        • Walker A.H.C.
        The maternal circulation in normal pregnancy.
        Journal of Obstetrics and Gynaecology of the British Empire. 1949; 56: 537
        • Phippard A.F.
        • Horvath J.S.
        • Glynn E.M.
        Circulatory adaptation to pregnancy—serial studies of haemodynamics, blood volume, renin, and aldosterone in the baboon (Papio hamadryas.
        J Hypertens. 1986; 4: 773
        • Pritchard J.A.
        Blood volume changes in pregnancy and the puerperium. IV. Anemia associated with hydatidiform mole.
        Am J Obstet Gynecol. 1965; 91: 621
        • Pritchard J.A.
        Changes in the blood volume during pregnancy and delivery.
        Anesthesiology. 1965; 26: 393
        • Pritchard J.A.
        • Baldwin R.M.
        • Dickey J.C.
        • et al.
        Blood volume changes in pregnancy and the puerperium. II. Red blood cell loss and changes in apparent blood volume during and following vaginal delivery, cesarean section, and cesarean section plus total hysterectomy.
        Am J Obstet Gynecol. 1962; 84: 1271
        • Pritchard J.A.
        • Cunningham F.G.
        • Pritchard S.A.
        The Parkland Memorial Hospital protocol for treatment of eclampsia: Evaluation of 245 cases.
        Am J Obstet Gynecol. 1984; 148: 951
        • Prowse C.M.
        • Gaensler E.A.
        Respiratory and acid-base changes during pregnancy.
        Anesthesiology. 1965; 26: 381
        • Reiss R.E.
        • Tizzano T.P.
        • O'Shaughnessy R.W.
        The blood pressure course in primiparous pregnancy. A prospective study of 383 women.
        J Reprod Med. 1987; 32: 523
        • Robson S.C.
        • Dunlop W.
        • Boys R.J.
        • et al.
        Cardiac output during labor.
        Br Med J. 1987; 295: 1169
        • Robson S.C.
        • Dunlop W.
        • Moore M.
        • et al.
        Combined Doppler and echocardiographic measurement of cardiac output: Theory and application in pregnancy.
        Br J Obstet Gynaecol. 1987; 94: 1014
        • Robson S.C.
        • Hunter R.
        • Boys W.
        • et al.
        Changes in cardiac output during epidural anaesthesia for Caesarean section: Anaesthesia. 1989; 44: 475
        • Robson S.C.
        • Hunter S.
        • Boys R.J.
        • et al.
        Serial study of factors influencing changes in cardiac output during human pregnancy.
        Am J Physiol. 1989; 256: H1060
        • Robson S.C.
        • Hunter S.
        • Moore M.
        • et al.
        Haemodynamic changes during the puerperium: A Doppler and M-mode echocardiographic study.
        Br J Obstet Gynaecol. 1987; 94: 1028
        • Skatrud J.J.B.
        • Dempsey J.A.
        • Kaiser D.G.
        Ventilatory response to medroxyprogesterone acetate in normal subjects: Time course and mechanism.
        J Appl Physiol: Respir Environ Exercise Physiol. 1978; 44: 939
        • Symonds E.M.
        Renin-angiotensin system in normal and hypertensive pregnancy.
        in: Lewis P.J. Moncada S. O'Grady J. Prostacyclin in pregnancy. Raven Press, New York1983: 91
        • Templeton A.
        • Kelman G.R.
        Maternal blood-gases, (PAO2-PaO2), physiologic shunt, and VD/VT in normal pregnancy.
        Br J Anaesth. 1976; 48: 1001
        • Ueland K.
        Maternal cardiovascular dynamics: VII. Intrapartum blood volume changes.
        Am J Obstet Gynecol. 1976; 126: 671
        • Ueland K.
        • Hansen J.
        Maternal cardiovascular dynamics: II. Posture and uterine contractions.
        Am J Obstet Gynecol. 1969; 103: 1
        • Ueland K.
        • Hansen J.
        • Eng M.
        • et al.
        Maternal cardiovascular hemodynamics: VI. Cesarean section under thiopental, nitrous oxide, and succinylcholine anesthesia.
        Am J Obstet Gynecol. 1970; 106: 615
        • Ueland K.
        • Novy M.J.
        • Peterson E.N.
        • et al.
        Maternal cardiovascular dynamics: IV. The influence of gestational age on the maternal cardiovascular response to posture and exercise.
        Am J Obstet Gynecol. 1969; 104: 856
        • Vorys N.
        • Ullery J.C.
        • Hanusek G.E.
        The cardiac output changes in various positions in pregnancy.
        Am J Obstet Gynecol. 1961; 82: 1312
        • Walters W.A.W.
        • Lim Y.L.
        Cardiovascular dynamics in women receiving oral contraceptive therapy.
        Lancet. 1969; 2: 879
        • Walters W.A.W.
        • MacGregor W.G.
        • Hills M.
        Cardiac output at rest during pregnancy and the puerperium.
        Clin Sci. 1966; 30: 1
        • Warren J.V.
        • Elkin D.C.
        • Nicerson J.L.
        The blood volume in patients with arteriovenous fistulas.
        J Clin Invest. 1951; 30: 220
        • Wickman K.
        • Ryden G.
        • Wichman G.
        The influence of different positions and Korotkoff sounds on the blood pressure measurements in pregnancy.
        Acta Obstet Gynaecol Scand (Suppl. 1984; 118: 25
        • Wilson M.
        • Morganti A.A.
        • Zervoudakis I.
        • et al.
        Blood pressure, the renin-aldosterone system, and sex steroids throughout normal pregnancy.
        Am J Med. 1980; 68: 97
        • Zondervan H.A.
        • Voorhorst F.J.
        • Robertson E.A.
        • et al.
        Is maternal whole blood viscosity a factor in fetal growth?.
        Eur J Obstet Gynecol Reprod Riol. 1985; 20: 145

      Article info

      Identification

      DOI: https://doi.org/10.1016/S0749-0704(18)30279-3

      Copyright

      © 1991 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX