Document Detail

Cardiovascular responses to the change from the left lateral to the upright position in pregnant hypertensives.
MedLine Citation:
PMID:  15001367     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate by non-invasive means, the autonomically mediated changes in heart rate and blood pressure in response to postural change in pregnancy. METHODS: Ninety-one patients were studied, of whom 17 were non-pregnant controls, 21 were normotensive parturients, 22 had non-proteinuric hypertension, and 31 were pre-eclamptics. In all patients the heart rate and blood pressure response to the change from the left lateral to the erect position was measured non-invasively, during the third trimester in the pregnant groups. RESULTS: The change from the left lateral to the erect position induced significantly greater mean changes (increases) in systolic blood pressure in the normotensive pregnant (PC) women than all other groups (P<0.05). Pre-eclamptic patients (PE) exhibited significantly less of an increase in systolic blood pressure than the non-proteinuric hypertensive (H) group. Both the H and PC groups showed significantly greater increases in diastolic pressure than the non-pregnant (NP) group. PE patients had a significantly smaller increase in diastolic pressure than the H group. There were no significant differences between heart rate changes when comparing the PC, NP and H groups. The PE group exhibited a significantly greater increase in heart rate on adopting the erect position than all other groups. CONCLUSIONS: Pre-eclamptics exhibit smaller changes in blood pressure than normotensive pregnant patients and non-proteinuric hypertensives on standing, while producing an exaggerated heart rate response, indicating altered autonomic compensatory mechanisms in these patients.
R A Dyer; J Anthony; Q Ledeboer; M F James
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  84     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-05     Completed Date:  2004-06-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  208-13     Citation Subset:  IM    
Department of Anaesthesia, University of Cape Town and New Groote Schuur Hospital, Cape Town, South Africa.
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MeSH Terms
Autonomic Nervous System / physiology
Blood Pressure / physiology*
Heart Rate / physiology*
Posture / physiology*
Pre-Eclampsia / physiopathology
Pregnancy Complications, Cardiovascular / physiopathology*

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