Document Detail

The haemodynamic, renal excretory and hormonal changes induced by resting in the left lateral position in normal pregnant women during late gestation.
MedLine Citation:
PMID:  19781045     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To characterise the haemodynamic, renal-electrolyte and hormonal parameters in normal near-term pregnancy. DESIGN: Observational prospective case-series study. SETTING AND POPULATION: Eleven women with normal pregnancies at 35-39 weeks gestation. METHODS: Following baseline laboratory assessments and placement of a right-atrial catheter, serial measurements were obtained for 2 hours in the supine position (SP) followed by a change to the (LLP) and subsequent observations for 2 hours. MAIN OUTCOME MEASURES: Blood pressure (BP), central venous pressure (CVP), atrial natriuretic peptide (ANP), plasma renin activity (PRA), plasma aldosterone (ALDO), diuresis, creatinine clearance, sodium and potassium excretion. RESULTS: In the SP, the subjects' BP remained stable while their CVP decreased. In the LLP, the subjects' systolic and diastolic BP consistently decreased by about 15 mmHg and their CVP increased within the first 60 minutes. ANP levels doubled in the subjects while they rested in the LLP, whereas the subjects' PRA and ALDO levels decreased by half compared with when they rested in the SP. In the LLP, the subjects' creatinine clearance significantly increased by 12% and their sodium excretion and diuresis increased by 38% and 59% respectively. CONCLUSION: Rest in the LLP induces systemic and intra-renal haemodynamic and hormonal changes that may play a central physiological role in the renal excretory response to restore excessive sodium/water retention in late pregnancy.
F A Almeida; M V Pavan; C I S Rodrigues
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-14
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  116     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-12     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1749-54     Citation Subset:  AIM; IM    
Nephrology Division, Department of Medicine, Centro de Ci??ncias M??dicas e Biol??gicas, PUC/SP, Sorocaba, SP, Brazil.
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MeSH Terms
Adaptation, Physiological
Aldosterone / blood
Atrial Natriuretic Factor / blood
Blood Pressure / physiology*
Creatinine / urine
Diuresis / physiology
Kidney / metabolism*
Posture / physiology
Potassium / urine
Pregnancy / blood,  physiology*,  urine
Pregnancy Trimester, Third / blood,  physiology,  urine
Renin / blood
Sodium / urine
Supine Position / physiology
Young Adult
Reg. No./Substance:
52-39-1/Aldosterone; 60-27-5/Creatinine; 7440-09-7/Potassium; 7440-23-5/Sodium; 85637-73-6/Atrial Natriuretic Factor; EC

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