Autonomic cardiovascular reflexes in pregnancy. A longitudinal study

Ekholm, Eeva; Piha, S. J.; Erkkola, Risto; Antila, Kari

doi:10.1007/bf01826181

Cited by 64 publications

(59 citation statements)

References 17 publications

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“…Moreover, in orthostatic position heart rate and diastolic blood pressure variability of healthy pregnants were lower compared to non-pregnant women, confirming the possibility of changes in the baroreflex control and increased maternal blood volume to be involved. 20 Nevertheless, in our study, normal pregnant and pre-eclamptic women showed significantly increased heart rate with standing, also if the increase was lower compared to non-pregnant women (9.8% and 13.8%, vs 21.9%, respectively).…”

Section: Discussioncontrasting

confidence: 59%

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Baroreflex control of heart rate is impaired in pre-eclampsia

et al. 1999

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Autonomic nervous dysfunction, such as parasympathetic and sympathetic impairment, has been suggested as possible cause of pre-eclampsia, but the studies are not conclusive. Our purpose was to assess non-invasively if pre-eclampsia is associated with a decreased baroreflex function. Nine women with pre-eclampsia (PE), eight normotensive pregnant women, and seven healthy normotensive non-pregnant women were studied. Continuous finger blood pressure was recorded by a Portapres device in the left lateral recumbent position and active standing. Baroreflex gain was evaluated by

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Section: Discussioncontrasting

confidence: 59%

“…[20][21][22][23] On the contrary, many animal studies 24,25 showed pregnancy to be associated with an impaired baroreflex sensitivity, and an attenuated ability to increase sympathetic outflow above baseline levels during a hypotensive challenge.…”

Section: Discussionmentioning

confidence: 99%

Baroreflex control of heart rate is impaired in pre-eclampsia

et al. 1999

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“…[17] In our study of HR response to deep breathing, the ratio of maximum-to-minimum RR-interval during respiratory cycles, that is, the E/I ratio of RR intervals, was found to be significantly less in the second trimester compared to controls. In accordance with our results, many studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] showed HR response to deep breathing expressed as deep breathing difference (DBD), a measure of cardiac parasympathetic function was observed to be significantly lower in pregnant women when compared to control group and generally followed a decreasing trend with increase in gestation. [4] This finding was in conformity with observation of Ekholm et al who suggested a multifactorial basis for it.…”

Section: Discussionsupporting

confidence: 88%

“…[19] A diminished parasympathetic input to the heart during pregnancy has been attributed to, reduced baroreceptor sensitivity, impaired vagal afferents to brain and altered efferent signals to the heart. [20] A reduction in oscillation of the right atrial distension arising from diminished pulsatility of venous return from the growing uterus has been described in pregnant subjects, which may account for the lowering of DBD in pregnancy. [4] …”

Section: Discussionmentioning

confidence: 99%

A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

Athani¹,

Kallur²

2018

Natl J Physiol Pharm Pharmacol

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Background: Normal pregnancy has been documented to be accompanied by marked alteration in maternal circulation during the first and second trimesters. For adapting the cardiovascular hemodynamic changes during normal pregnancy, a well-controlled interaction between the sympathetic and parasympathetic system is very essential, failure of which may result in pregnancy-related complications. Aims and Objectives: To evaluate and compare the cardiovascular autonomic function tests (AFTs) between the second trimester pregnant women and controls. Materials and Methods: A cross-sectional study was conducted by random selection of 67 s trimester pregnant women and 67 controls in the age group of 19-29 years. The cardiovascular AFTs were carried out. The statistical analysis was done using unpaired t-test. Results: During isometric handgrip exercise, the maximum rise in diastolic blood pressure (DBP), and during cold pressor test, the maximum rise in systolic BP and maximum rise in DBP were significantly less in the second trimester of pregnancy than controls. There was significantly less increase in 30:15 ratio and E: I ratio of the second trimester pregnant women when compared to controls. Conclusion: The cardiovascular autonomic nervous activity was decreased in the second trimester of pregnancy when compared to controls.

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“…It is known that maternal hemodynamic disturbances play an important role in the development of several diseases in pregnancy, which was demonstrated by Jia et al [12] using noninvasive assessment of maternal cardiovascular parameters. In the presence of maternal heart disease, the main issue is to assess the consequences of disease progression due to the adaptation of the cardiovascular system to pregnancy: plasma catecholamine concentrations and adrenergic receptor sensitivity increase [13]. …”

Section: Discussionmentioning

confidence: 99%

Successful Obstetric Management of Arrhythmogenic Right Ventricular Cardiomyopathy

Cozzolino

Perelli²,

Corioni³

et al. 2014

Gynecol Obstet Invest

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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic myocardial disorder characterized by the replacement of myocardium by fibro-adipose tissue. The proper obstetric management of this disease remains unclear due to the lack of an adequate number of cases reported in the literature. We report the successful management of a pregnant patient with ARVC. A female patient with ARVC presented to our hospital at 9 weeks of gestation. Before pregnancy, she was treated with bisoprolol, which resulted in a reduction in extrasystoles and she never developed palpitations. Periodical cardiological examinations showed clinical stability, and the only therapeutic change consisted of an increase in the bisoprolol dosage. She delivered at term by elective cesarean section. We decided that avoiding changes in the chronic therapy of our patient was the best management because she had reached clinical stability before pregnancy and discontinuation of therapy may pose an addition risk. In our opinion, cesarean section was the best mode of delivery in our ARVC patient to avoid the stress of labor, which may raise heart rate and cause arrhythmia. Our experience and the case reports in the literature suggest that pregnancy is tolerated in female patients with ARVC, but they need to be monitored during pregnancy by a multidisciplinary team.

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Autonomic cardiovascular reflexes in pregnancy. A longitudinal study

Cited by 64 publications

References 17 publications

Baroreflex control of heart rate is impaired in pre-eclampsia

Baroreflex control of heart rate is impaired in pre-eclampsia

A comparative study of cardiovascular autonomic function tests between second trimester pregnant women and non-pregnant women

Successful Obstetric Management of Arrhythmogenic Right Ventricular Cardiomyopathy

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