Passive Leg Raising during Pregnancy

Marques, Nicole Ribeiro; Martinello, Caroline; Kramer, George C.; Costantine, Maged M.; Vadhera, Rakesh; Saade, George R.; Hankins, Gary D.V.; Pacheco, Luis D.

doi:10.1055/s-0034-1389089

Cited by 15 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are in agreement with those of a study of 108 healthy pregnant women at 22–24 weeks' gestation and 54 non‐pregnant women that reported that, in both groups, passive leg raising was associated with an increase in stroke volume and a decrease in systemic vascular resistance. In contrast, a study in 47 healthy pregnant women at around 39 weeks' gestation reported that passive leg raising was associated with a significant decrease in heart rate and no change in cardiac index, stroke volume or systemic vascular resistance. The differences here could be due to the difference in gestational age at assessment.…”

Section: Discussionsupporting

confidence: 91%

Effect of change in posture on maternal functional hemodynamics at 35–37 weeks' gestation

Guy

Ling

Machuca

et al. 2018

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Paradoxically, in late third-trimester normal pregnancy, both change from the supine to a sitting position and passive leg raising may result in an increase in preload with a consequent increase in cardiac and stroke volume indices and a decrease in total peripheral resistance index. In pregnancies that develop PE or GH, the effects of postural change on cardiovascular parameters are similar but less marked than in normotensive pregnancies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

Section: Discussionsupporting

confidence: 91%

Effect of change in posture on maternal functional hemodynamics at 35–37 weeks' gestation

Guy

Ling

Machuca

et al. 2018

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…However, the baseline measurements of cardiovascular function obtained during the second half of pregnancy in this study were similar to those reported previously by us [ 7 ] and others [ 8 ] using similar equipment and methodology. A study performed on pregnant women at term [ 34 ] reported no significant difference between CO measured at baseline and during PLR in the semi-recumbent or left lateral decubitus positions, but a decrease in CO during PLR in the right-lateral decubitus position. This was a cross-sectional study that used a different method (pulse contour analysis) and device (ccNexfin; Edwards Lifesciences, Irvine, CA) to estimate the CO.…”

Section: Discussionmentioning

confidence: 99%

Maternal Functional Hemodynamics in the Second Half of Pregnancy: A Longitudinal Study

et al. 2015

View full text Add to dashboard Cite

ObjectiveCardiovascular response to passive leg raising (PLR) is useful in assessing preload reserve, but it has not been studied longitudinally during pregnancy. We aimed to investigate gestational age associated serial changes in maternal functional hemodynamics and establish longitudinal reference ranges for the second half of pregnancy.Materials and MethodsThis was a prospective longitudinal study on 98 healthy pregnant women who were examined 3–5 times during 20–40 weeks of gestation (a total of 441 observations). Maternal cardiac function and systemic hemodynamics were assessed at baseline and 90 seconds after PLR using impedance cardiography (ICG). The main outcome measures were gestational age specific changes in ICG-derived variables of maternal cardiovascular function and functional hemodynamic response to PLR.ResultsHemodynamic response to PLR varied during pregnancy. PLR led to an insignificant increase in stroke volume during 20+0 to 31+6 weeks, but later in gestation the stroke volume was slightly lower at PLR compared to baseline. PLR caused no significant change in cardiac output between 20+0 and 23+6 weeks and a significant decrease after 24+0 weeks. A decrease in heart rate, mean arterial pressure, and cardiac contractility was observed during PLR throughout the second half of pregnancy. Systemic vascular resistance was reduced by PLR up to 32+0 weeks, but increased slightly thereafter.ConclusionHealthy pregnant women appear to have limited preload reserve and reduced cardiac contractility, especially in the third trimester, which makes them vulnerable to fluid overload and cardiac failure.

show abstract

“…30 Passive leg raising may not be useful during the third trimester because of uterine compression of the inferior vena cava and should not be used to guide therapy. 31 In such cases, an increase in cardiac output may be identified by administering a small bolus of fluid (250e500 mL); if the cardiac output increases after such an intervention, further fluid administration is likely indicated. In a mechanically ventilated patient with an arterial line, pulse-pressure variation may be used as an alternative way to assess fluid responsiveness.…”

Section: What Is the Role Of Fluid Therapy In The Management Of Sepsis?mentioning

confidence: 99%

SMFM Consult Series #47: Sepsis during pregnancy and the puerperium

Plante

Pacheco

Louis

2019

American Journal of Obstetrics and Gynecology

104

View full text Add to dashboard Cite

Passive Leg Raising during Pregnancy

Abstract: PLR did not result in cardiac output recruitment in a cohort of healthy pregnant women during the third trimester.

Cited by 15 publications

References 12 publications

Effect of change in posture on maternal functional hemodynamics at 35–37 weeks' gestation

Effect of change in posture on maternal functional hemodynamics at 35–37 weeks' gestation

Maternal Functional Hemodynamics in the Second Half of Pregnancy: A Longitudinal Study

SMFM Consult Series #47: Sepsis during pregnancy and the puerperium

Contact Info

Product

Resources

About