Document Detail


Maternal cardiovascular changes from pre-pregnancy to very early pregnancy.
MedLine Citation:
PMID:  22940682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our aim was to assess changes in maternal cardiovascular haemodynamics, including central blood pressure (BP), wave reflections and aortic stiffness, from pre-pregnancy to very early pregnancy.
METHODS: Fifty-six healthy nulliparous or women with previous uncomplicated pregnancy were studied prior to conception and in very early pregnancy. Assessments of brachial and central BPs, pulse wave reflection quantified by augmentation index (AIx), aortic stiffness using carotid femoral pulse wave velocity (aPWV) and cardiac output (CO) were performed.
RESULTS: Pregnancy measurements were obtained at median gestational age of 6.3 weeks [interquartile range (IQR) 6-6.5 weeks] from the last menstrual period. Whilst heart rate (HR) increased from 67  ±  10 to 71  ±  10  bpm. (P  =  0.001), brachial SBP, DBP and central SBP were all lower than the pre-pregnancy values (109  ±  10 to 104  ±  7 mmHg, 72  ±  8 to 65  ±  6 mmHg and 99  ±  10 to 92  ±  7 mmHg, respectively; P  <  0.001 for all). AIx adjusted for HR fell (19  ±  10 to 13  ±  9%; P  =  0.001) as did peripheral vascular resistance (PVR; 1234 ± 229 to 1128  ±  280 dynes/s/cm; P = 0.003). aPWV adjusted for mean arterial pressure (MAP) was unchanged (5.3  ±  0.6 to 5.1  ±  0.6m/s; P  =  0.2).
CONCLUSION: Significant changes occur in brachial and central BP, AIx and PVR in successful, ongoing pregnancies, by about 6-7 weeks gestation; much earlier than has hitherto been assumed. Using late first trimester data as 'baseline' cannot be relied on to estimate the extent of cardiovascular changes in normal pregnancy. Future studies of cardiovascular changes in pregnancy should, therefore, have a pre-pregnancy starting point.
Authors:
Amita A Mahendru; Thomas R Everett; Ian B Wilkinson; Christoph C Lees; Carmel M McEniery
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  30     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-11     Completed Date:  2013-03-22     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2168-72     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology
Cardiac Output / physiology
Cardiovascular Physiological Processes*
Cohort Studies
Female
Hemodynamics / physiology
Humans
Pregnancy / physiology*
Pregnancy Trimester, First / physiology
Prospective Studies
Pulse Wave Analysis
Reference Values
Time Factors
Vascular Stiffness / physiology
Grant Support
ID/Acronym/Agency:
FS/12/8/29377//British Heart Foundation; //British Heart Foundation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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