The effect of position and delay on stroke and minute distance in late pregnancy

Rawles, John; Schneider, K. T. M.; Hugh, R.; Huch, A.

doi:10.1111/j.1471-0528.1987.tb03141.x

Cited by 10 publications

(3 citation statements)

References 6 publications

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“…The explanation for these discrepant results may also partly reside in the observation that in late pregnancy the sequence as well as the position in which the measurements are made may affect the value of minute distance (Rawles et al 1987).…”

Section: F M Mclennan Et A1mentioning

confidence: 98%

Stroke and minute distance in pregnancy: a longitudinal study using Doppler ultrasound

Mclennan

Haites

Rawles

1987

BJOG

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Summary Using Doppler ultrasound directed at the aortic arch, stroke and minute distance were measured in 45 normal singleton pregnancies and compared with 42 controls. In the non‐pregnant controls, stroke distance was 5% more in the supine than in the left lateral position (P<0·01) and during pregnancy this relativity was maintained until 36 weeks gestation. In the supine and left lateral positions respectively, stroke distance was increased by 8% (both) at 4 weeks (P<0·05 and NS), by 14 and 11% at 8 weeks (P<0·001 and P<0·01) and showed a maximum increase of 21 and 20% at 16 weeks gestation (both P<0·001). At 40 weeks, supine stroke distance was 14% less than the non‐pregnant control value (P<0·001), and 6% less than the value in the left lateral position (P<0·05), which was itself not significantly different from that in the non‐pregnant controls. The maximum increase of heart rate was at 32 weeks, by 24% in the supine and by 19% in the left lateral position (both P<0·001). Minute distance was maximally increased by 37% in the supine at 16 weeks (P<0·001) and by 30% in the left lateral position at 24 weeks (P<0·001). Thereafter, minute distance, measured in both positions, declined until at 40 weeks it was not significantly different from the non‐pregnant control value.

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Section: F M Mclennan Et A1mentioning

confidence: 98%

Stroke and minute distance in pregnancy: a longitudinal study using Doppler ultrasound

Mclennan

Haites

Rawles

1987

BJOG

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“…Maternal hemodynamics, in response to different body positions assumed during doctor appointments, clinical exams or physiotherapy treatment sessions, can influence fetal heart rate patterns 1. Aortocaval compression occurs when the maternal position causes the pregnant uterus to exert backwards force, thus causing a reduction in venous return, cardiac output and arterial blood pressure 2,3.…”

Section: Introductionmentioning

confidence: 99%

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Oliveira¹,

Lopes²,

Rodrigues³

et al. 2017

Clinics

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OBJECTIVES:To analyze the influence of lying in prone position on a specially designed stretcher on the maternal-fetal hemodynamic parameters and comfort of pregnant women.METHODS:A randomized, controlled trial with 33 pregnant women divided into 2 groups: pregnant group sequence 1 and pregnant group sequence 2. The order of positions used in sequence 1 was Fowler’s position, prone position, supine position, left lateral, Fowler’s position 2, supine position 2, prone position 2 and left lateral 2. The order of positions used in sequence 2 was Fowler’s position, prone position, left lateral, supine position, Fowler’s position 2, left lateral 2, prone position 2 and supine position 2. Each woman remained in each position for 6 minutes. For the statistical analyses, we used Wilcoxon’s test for 2 paired samples when comparing the prone position with the other positions. The variables are presented in graphs showing the means and 95% confidence intervals. Trial Registration: Clinical Trial No. ISRCTN41359519RESULTS:All the parameters were within the standards of normality. There were no differences between positions in terms of maternal heart rate, diastolic blood pressure, oxygen saturation and fetal heart rate. However, there were significant decreases in respiratory rate and systolic blood pressure in prone position 2 compared with left lateral 2. There was an increase in oxygen saturation in prone position compared with Fowler’s position and supine position 2 in both sequences. All the women reported feeling comfortable in the prone position.CONCLUSIONS:The prone position was considered safe and comfortable and could be advantageous for improving oxygen saturation and reducing the systolic blood pressure and respiratory rate.

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“…However, most of these studies may offer a realistic representation of the mixture of risk present in routine clinical care. Rawles et al 32 demonstrated that even the sequence of shifting position might influence measurements. In addition, the various noninvasive methods of functional haemodynamic monitoring used to estimate stroke volume, cardiac output or even peripheral vascular resistance, include echocardiography, 30 bioimpedance cardiography, 15 acetylene rebreathing technique, 21 suprasternal Doppler ultrasound, 26 MRI phase-contrast images of the aorta, 17,18 cardiovascular magnetic resonance, 24 electrical cardiometry (ICON) 29 and noninvasive cardiac output monitoring (NICOM) 33 .…”

Section: Haemodynamic Measurements In the Supine Positionmentioning

confidence: 99%

Supine hypotensive syndrome of pregnancy

Massoth

Chappell

Kranke

et al. 2021

European Journal of Anaesthesiology

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Since the first description of supine hypotensive syndrome in the 1950s, its potentially detrimental effects on otherwise healthy women during late pregnancy have become a persistent challenge in obstetric practice. Establishing a 158 left lateral tilt during labour and caesarean section is a fundamental principle of obstetric care, universally adopted and upheld by current guidelines and recommendations. Reassessment of the original landmark studies in the light of current physiological and anatomical knowledge questions adherence to this standard in clinical practice. The modern practice of providing vasopressor support during caesarean delivery under neuraxial anaesthesia appears to negate any potential negative effects of a maternal full supine position. Recent MRI studies provide evidence as to the cause of supine hypotension and the physiological effects of different maternal positions at term. This review highlights current data on the acute supine hypotensive syndrome in contrast to traditional knowledge and established practice.

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The effect of position and delay on stroke and minute distance in late pregnancy

Cited by 10 publications

References 6 publications

Stroke and minute distance in pregnancy: a longitudinal study using Doppler ultrasound

Stroke and minute distance in pregnancy: a longitudinal study using Doppler ultrasound

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Supine hypotensive syndrome of pregnancy

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