Venous adjustments in healthy and hypertensive pregnancy

Krabbendam, Ineke; Spaanderman, Marc E. A.

doi:10.1586/17474108.2.5.671

Cited by 10 publications

(10 citation statements)

References 94 publications

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“…This returns to prepregnant values in the first 3 months postpartum46. During pregnancy, venous compliance and the inferior vena cava diameter increase by 30% and up to 70%, respectively, relative to prepregnant values47. The absence of change in left atrium diameter in early gestation48, 49 in conjunction with the absence of increase in atrial natriuretic peptide (ANP), facilitates plasma volume expansion during this period50.…”

Section: Gestational Adaptation Of the Maternal Venous Compartmentmentioning

confidence: 99%

“…The absence of change in left atrium diameter in early gestation48, 49 in conjunction with the absence of increase in atrial natriuretic peptide (ANP), facilitates plasma volume expansion during this period50. In contrast, circulating ANP levels tend to increase in the second half of pregnancy47, which may explain, at least in part, the decreasing trend in plasma volume in the third trimester of pregnancy. Further, after the 28 th week hepatic flow increases, presumably because of a higher portal flow due to more drainage from the splanchnic bed51.…”

Section: Gestational Adaptation Of the Maternal Venous Compartmentmentioning

confidence: 99%

“…Several weeks prior to the onset of clinical pre‐eclampsia, plasma volume is diminished and, compared to normal pregnancy, levels of progesterone and aldosterone are increased and decreased, respectively57. Also, the pregnancy‐induced changes in the venous bed seem to fade, as indicated by reversal of the changes in venous distensibility45, capacitance58 and compliance47. In nearly half of the women with a history of pre‐eclampsia, subnormal plasma volume persists postpartum59, along with a low venous capacitance60 and impaired venular drainage of the conjunctival microcirculation61.…”

Section: Maternal Venous Hemodynamic Maladaptation In Pre‐eclampsiamentioning

confidence: 99%

“…Further, these women have a three‐fold higher risk of developing recurrent pre‐eclampsia in their next pregnancy64. When pregnant again, these women respond as if their vascular bed was relatively overfilled, as indicated by an aberrant rise in the left atrial diameter and in ANP release during the first weeks of pregnancy47. Together, these data support the view that such women have a chronically reduced venous capacity and a more rigid venous compartment than women who had an uneventful pregnancy.…”

Section: Maternal Venous Hemodynamic Maladaptation In Pre‐eclampsiamentioning

confidence: 99%

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Role of dysfunctional maternal venous hemodynamics in the pathophysiology of pre‐eclampsia: a review

Gyselaers

Mullens

Tomsin

et al. 2011

Ultrasound in Obstet & Gyne

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Section: Gestational Adaptation Of the Maternal Venous Compartmentmentioning

confidence: 99%

Section: Gestational Adaptation Of the Maternal Venous Compartmentmentioning

confidence: 99%

Section: Maternal Venous Hemodynamic Maladaptation In Pre‐eclampsiamentioning

confidence: 99%

Section: Maternal Venous Hemodynamic Maladaptation In Pre‐eclampsiamentioning

confidence: 99%

See 2 more Smart Citations

Role of dysfunctional maternal venous hemodynamics in the pathophysiology of pre‐eclampsia: a review

Gyselaers

Mullens

Tomsin

et al. 2011

Ultrasound in Obstet & Gyne

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show abstract

“…We included 9 normotensive nonpregnant formerly preeclamptic women with a median age of 34 (31)(32)(33)(34)(35)(36)(37) …”

Section: Resultsmentioning

confidence: 99%

Exercise-induced Changes in Venous Vascular Function in Nonpregnant Formerly Preeclamptic Women

et al. 2009

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Objective: Formerly preeclamptic women with low plasma volume are at increased risk of recurrent gestational hypertensive disease. We hypothesized that a 4-week cycling training in formerly preeclamptic women improves (venous) hemodynamic function. Methods: In 9 formerly preeclamptic women, we examined physical fitness and hemodynamic function, before and after the training.We assessed blood pressure, heart rate, cardiac output, plasma volume, and calf and forearm venous compliance. Results: After the training, baseline blood pressure and cardiac output remained unchanged, but resting heart rate decreased (-7%, P ¼ .02). Plasma volume was 8% higher after training (P ¼ .01). Calf venous compliance increased (þ18%, P ¼ .02) but not forearm venous compliance (þ14%, P ¼ .09). Conclusion: Cycling training improves venous vascular function in formerly preeclamptic women. The decreased resting heart rate and improvement of venous compliance suggest reduced sympathetic activity. These rapid exercise-induced changes may improve maternal vascular adaptation in early pregnancy and with it the risk of (recurrent) gestational hypertensive disease.

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Ventricular wall stress and wall shear stress homeostasis predicts cardiac remodeling during pregnancy: A modeling study

Comunale

Susin

Mynard

2021

Numer Methods Biomed Eng

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Pregnancy is a unique and dynamic process characterized by significant changes in the maternal cardiovascular system that are required to satisfy the increased maternal and fetal metabolic demands. Profound structural and hemodynamic adaptations occur during healthy pregnancy that allows the mother to maintain healthy hemodynamics and provide an adequate uteroplacental blood circulation to ensure physiological fetal development.Investigating these adaptations is crucial for understanding the physiology of pregnancy and may provide important insights for the management of high-risk pregnancies. However, no previous modeling studies have investigated the maternal cardiac structural changes that occur during gestation. This study, therefore, had two aims. The first was to develop a lumped parameter model of the whole maternal circulation that is suitable for studying global hemodynamics and cardiac function at different stages of gestation. The second was to test the hypothesis that myofiber stress and wall shear stress homeostasis principles can be used to predict cardiac remodeling that occurs during normal pregnancy. Hemodynamics and cardiac variables predicted from simulations with and without controlled cardiac remodeling algorithms were compared and evaluated with reference clinical data. While both models reproduced the hemodynamic variations that arise in pregnancy, importantly, we show that the structural changes that occur with pregnancy could be predicted by assuming invariant homeostatic "target" values of myocardial wall stress and chamber wall shear stress.

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Venous adjustments in healthy and hypertensive pregnancy

Cited by 10 publications

References 94 publications

Role of dysfunctional maternal venous hemodynamics in the pathophysiology of pre‐eclampsia: a review

Role of dysfunctional maternal venous hemodynamics in the pathophysiology of pre‐eclampsia: a review

Exercise-induced Changes in Venous Vascular Function in Nonpregnant Formerly Preeclamptic Women

Ventricular wall stress and wall shear stress homeostasis predicts cardiac remodeling during pregnancy: A modeling study

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