Adaptation of maternal central hemodynamics in the third trimester of single and multiple pregnancies
- Authors: Makarov R.A.1, Kinzhalova S.V.1, Mamovich N.V.1, Markova T.V.1
-
Affiliations:
- USRIMCC of Minzdrav of Russia
- Issue: No 2 (2019)
- Pages: 74-77
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248432
- DOI: https://doi.org/10.18565/aig.2019.2.74-77
- ID: 248432
Cite item
Open Access
Access granted
Abstract
Objective. To compare central hemodynamics in non-pregnant women with that in women with singleton and multiple pregnancies, late in the third trimester before delivery. Materials and methods. This study used non-invasive bioimpedance analysis to examine central hemodynamics in 20 non-pregnant somatically healthy women and 100 patients in the third trimester of pregnancy including 60 patients with singleton pregnancies and 40 women with twin pregnancies. Results. A comparative analysis of the study findings across the groups showed significant differences in the main parameters of central hemodynamics. Patients with multiple pregnancies had significantly lower stroke volume, cardiac index, oxygen delivery index and higher total peripheral vascular resistance than non-pregnant women and women with singleton pregnancies. Conclusion. When choosing anesthesia and preoperative care for the prevention of intraoperative arterial hypotension and disorders of uteroplacental perfusion, incomplete removal of aortocaval compression in patients with multiple pregnancies should be taken into account.
Keywords
Full Text
About the authors
Roman A. Makarov
USRIMCC of Minzdrav of Russia
Email: r_makarov_ekb@mail.ru
PhD, senior researcher at the Department of Intensive Care and Emergency Medicine
Svetlana V. Kinzhalova
USRIMCC of Minzdrav of Russia
Email: sveking@mail.ru
MD, associate professor, head of the Department of Intensive Care and Emergency Medicine
Natalya V. Mamovich
USRIMCC of Minzdrav of Russia
Email: mamoshka_n@mail.ru
junior researcher at the Department of Intensive Care and Emergency Medicine
Tatyana V. Markova
USRIMCC of Minzdrav of Russia
Email: ta.ma.vl@mail.ru
PhD, senior researcher at the Department of Ecology and Reproduction
References
- Sanghavi M., Rutherford J.D. Cardiovascular physiology ofpregnancy. Circulation. 2014; 130(12): 1003-8. doi: 10.1161/CIRCULATIONAHA.114.009029.
- Ouzounian J.G., Elkayam U. Physiologic changes during normal pregnancy and delivery. Cardiol. Clin. 2012; 30(3): 317-29. doi: 10.1016/j.ccl.2012.05.004.
- Melchiorre K., Sharma R., Thilaganathan B. Cardiac structure and function in normal pregnancy. Curr. Opin. Obstet. Gynecol. 2012; 24(6): 413-21. doi: 10.1097/GCO.0b013e328359826f.
- Ram M., Lavie A., Lev S., Blecher Y., Amikam U., Shulman Y. et al. Cardiac hemodynamics before, during and after elective cesarean section under spinal anesthesia in low-risk women. J. Perinatol. 2017; 37(7): 793-9. doi: 10.1038/ jp.2017.53.
- Desai D.K., Moodley J., Naidoo D.P. Echocardiographic assessment of cardiovascular hemodynamics in normal pregnancy. Obstet. Gynecol. 2004; 104(1): 20-9. doi: 10.1097/01.AOG.0000128170.15161.1d
- Volman M.N.M., Rep A., Kadzinska I., Berkhof J., van Geijn H.P., Heethaar R.M., de Vries J.I. Haemodynamic changes in the second half of pregnancy: a longitudinal, noninvasive study with thoracic electrical bioimpedance. BJOG. 2007; 114(5): 576-81. doi: 10.1111/j.1471-0528.2007.01300.x
- San-Frutos L., Engels V., Zapardiel I., Perez-Medina T., Almagro-Martinez J., Fernandez R., Bajo-Arenas J.M. Hemodynamic changes during pregnancy and postpartum: a prospective study using thoracic electrical bioimpedance. J. Matern. Fetal Neonatal Med. 2011; 24(11): 1333-40. doi: 10.3109/14767058.2011.556203.
- Kametas N.A., McAuliffe F., Krampi E., Chambers J., Nicolaides K.H. Maternal cardiac function in twin pregnancy. Obstet. Gynecol. 2003; 102(4): 806-15.
- Kuleva M., Youssef A., Maroni E., Nanni M., Pilu G., Rizzo N. et al. Maternal cardiac function in normal twin pregnancy: a longitudinal study. Ultrasound Obstet. Gynecol. 2011; 38(5): 575-80. doi: 10.1002/uog.8936.
- Сичинава Л.Г. Многоплодие. Современные подходы к тактике ведения беременности. Акушерство, гинекология и репродукция. 2014; 8(2): 131-8.
- Martin J.A., Hamilton B.E., Osterman M.J., Curtin S.C., Matthews T.J. Births: final data for 2013. Natl. Vital Stat. Rep. 2015; 64(1): 1-65.
- Краснопольский В.И., Новикова С.В., Цивцивадзе Е.Б., Жарова А.А. Ведение беременности и родов при многоплодной беременности. Альманах клинической медицины. 2015; 37: 32-40.
- Fox N.S., Roman A.S., Hastings J., Saltzman D.H., Hourizadeh T., Rebarber A. Blood pressure changes across gestation in patients with twin pregnancies. J. Matern. Fetal Neonatal Med. 2014; 27(9): 898-903. doi: 10.3109/14767058.2013.845660.
- Campbell D.M., Templeton A. Maternal complications of twin pregnancy. Int. J. Gynaecol. Obstet. 2004; 84(1): 71-3.
- Филиппович Г.В., Шифман Е.М. Анестезия операции кесарева сечения при многоплодной беременности. [Filippovich G.V., Shifman E.M. Anesthesia cesarean section for multiple pregnancies. (in Russian)] Available at: http:// www.critical.ru/actual/anest/multifruit.htm
Supplementary files
