Changes in baroreceptor sensitivity for heart rate during normotensive pregnancy and the puerperium

2000 ◽  
Vol 98 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Melanie J. BLAKE ◽  
Allison MARTIN ◽  
Brad N. MANKTELOW ◽  
Charles ARMSTRONG ◽  
Aidan W. HALLIGAN ◽  
...  

Normal pregnancy is associated with marked changes in cardiovascular haemodynamics, which in part may be due to changes in autonomic control mechanisms. Baroreflex sensitivity for heart rate (BRS) was calculated in the supine and standing positions using power spectral analysis of pulse interval (PI) and systolic blood pressure (SBP) in 16 normotensive pregnant women and 10 normotensive non-pregnant controls. The pregnant women were studied on three occasions during their pregnancy (early, mid- and late gestation) and once during the puerperium. Supine total SBP variability increased between early and late pregnancy by 79% [95% confidence intervals (CI) 30%, 145%; P < 0.001], and supine high-frequency PI variability decreased by 75% (CI 51%, 88%; P < 0.001). Supine BRS fell by 50% (P < 0.001), with values returning to early-pregnancy levels in the puerperium, which were similar to those recorded in the control group. Standing SBP variability and BRS values were unchanged during pregnancy and post partum. The low/high frequency ratio of PI variability, taken as a surrogate measure of sympathovagal balance, increased by 137% (CI 42%, 296%; P < 0.01) in the supine but not the standing position from early to late pregnancy. This was due to a decrease in high-frequency variability rather than to an increase in low-frequency variability, suggesting that these changes may have been due to vagal withdrawal rather than increased sympathetic activity. Normotensive pregnancy is associated with a marked decrease in supine BRS, although the exact mechanisms for these changes remain unclear. Further studies are required to define whether changes in BRS and sympathovagal tone in early pregnancy can be used to predict the onset of pregnancy-induced hypertension.

2001 ◽  
Vol 86 (3) ◽  
pp. 323-329 ◽  
Author(s):  
Paul G. Whittaker ◽  
Jon F.R. Barrett ◽  
Tom Lind

Studies of Fe absorption in pregnancy often make unfounded assumptions of erythrocyte incorporation. Therefore, we measured the absorption and utilisation of Fe during early and late pregnancy by the erythrocyte incorporation of two stable isotopes. 8·5 mg57Fe (oral) and 0·5 mg58Fe (intravenous) were given to five non-pregnant women, to five women in early gestation (12 weeks) and five women in late gestation (36 weeks). The stable isotope ratios in whole blood 14 d later were measured by MS. Together with estimation of body Fe mass, this enabled the calculation of Fe absorption and erythrocyte incorporation. In non-pregnant women, Fe absorption averaged 20·3 (range 10·2–34·3) %. It was not significantly different in early pregnancy (11·8 (range, 4·4–24·8) %), but during late pregnancy Fe absorption increased to 59·0 (range 38·2–77·2) %. All non-pregnant and early-pregnancy subjects had normal Fe status, but two women in late pregnancy had evidence of Fe insufficiency. During early and late pregnancy, mean erythrocyte incorporation was 63·4 (SD 12·1) % AND 71·0 (sd 10·4) % respectively, significantly reduced (P=0·003) compared with non-pregnant subjects (90·1 (sd 6·0) %). Decreased erythrocyte incorporation of absorbed Fe in early pregnancy is compatible with reduced Fe demand and low oral absorption. However, during late pregnancy decreased erythrocyte incorporation associated with high absorption and Fe insufficiency is different from the high erythrocyte incorporation which occurs in non-pregnant Fe-deficient women. This suggests that part of the aetiology of Fe deficiency during pregnancy may be the reduction of Fe utilisation.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zheng Ding ◽  
Fei Guo ◽  
Yulai Zhou ◽  
Xiaoyi Huang ◽  
Zhiwei Liu ◽  
...  

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P &lt; 0.001) and late pregnancy (P &lt; 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.


2011 ◽  
Vol 69 (2b) ◽  
pp. 336-341 ◽  
Author(s):  
L L Lunardi ◽  
A L C Costa ◽  
C A M Guerreiro ◽  
E A P Souza

It is assumed that 25% of patients with epilepsy are women of fertile age and 0.3% to 0.6% of all children are born of mothers with epilepsy. The aim of this study was to evaluate the quality of life on pregnant with epilepsy and compare with non-pregnant women with epilepsy. We evaluated two groups (Experimental Group - 29 pregnant women with epilepsy and Control Group - 30 women with epilepsy); they were attended at the HC/UNICAMP. The patients had three meetings to carry out and implement the anamnesis and the application of QQV-65. There were no significant differences in the measurement of quality of life when comparing both groups. However, when we analyzed individually in the pre- and post-partum periods, we observed significant differences in health aspects (p=0.0495), physical (p=0.02868) and emotional (p=0.0253) dimensions in QQV-65. This study shows that pregnancy could be interpreted as a stressor. In late pregnancy when this stressor was removed, women with epilepsy had improvement in their quality of life.


2020 ◽  
Vol 150 (12) ◽  
pp. 3224-3230
Author(s):  
Madeleine A Ennis ◽  
Anna-Joy Ong ◽  
Kenneth Lim ◽  
Ronald O Ball ◽  
Paul B Pencharz ◽  
...  

ABSTRACT Background Phenylalanine and tyrosine (referred to as total aromatic amino acids; TAAs) are essential for protein synthesis, and are precursors for important catecholamines. Current estimated average requirement (EAR) recommendations for TAA during pregnancy are 36 mg·kg−1·d−1, and has not been experimentally determined. Objectives The aim was to determine TAA requirements (dietary phenylalanine in the absence of tyrosine) during early and late gestation using the indicator amino acid oxidation (IAAO, with L-[1-13C]leucine) technique. Methods Nineteen healthy pregnant women (age 22–38 y) were studied at a range of phenylalanine intakes (5 to 100 mg·kg−1·d−1) in early (13–19 wk) and/or late (33–39 wk) pregnancy for a total of 51 study days. Graded test intakes were provided as 8 hourly isonitrogenous and isocaloric meals. Breath samples were collected for 13C enrichment analysis on an isotope ratio mass spectrometer. A plasma sample was collected and analyzed for phenylalanine and tyrosine concentrations on an amino acid analyzer. The TAA requirement in early and late pregnancy was calculated using 2-phase linear regression crossover analysis that identified breakpoints in 13CO2 production (the requirement) in response to phenylalanine intakes. Results TAA requirement during early pregnancy was 44 mg·kg−1·d−1 (95% CI: 28.3, 58.8) and during late pregnancy was 50 mg·kg−1·d−1 (95% CI: 36.1, 63.1). In early and late pregnancy, plasma phenylalanine and tyrosine concentrations rose linearly in response to graded phenylalanine intakes. Conclusions Our results suggest that the current EAR of 36 mg·kg−1·d−1 for TAAs is underestimated. When compared with results previously determined in nonpregnant adults, early pregnancy requirements were similar (43 compared with 44 mg·kg−1·d−1, respectively). During late pregnancy, a 14% higher TAA requirement was observed when compared with early pregnancy. The results from this study have potential implications for creating gestation stage-specific TAA recommendations.


2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joanne W. Y. Chung ◽  
Vincent C. M. Yan ◽  
Hongwei Zhang

Aim.To summarize all relevant trials and critically evaluate the effect of acupuncture on heart rate variability (HRV).Method.This was a systematic review with meta-analysis. Keyword search was conducted in 7 databases for randomized controlled trials (RCTs). Data extraction and risk of bias were done.Results.Fourteen included studies showed a decreasing effect of acupuncture on low frequency (LF) and low frequency to high frequency ratio (LF/HF ratio) of HRV for nonhealthy subjects and on normalized low frequency (LF norm) for healthy subjects. The overall effect was in favour of the sham/control group for high frequency (HF) in nonhealthy subjects and for normalized high frequency (HF norm) in healthy subjects. Significant decreasing effect on HF and LF/HF ratio of HRV when acupuncture was performed on ST36 among healthy subjects and PC6 among both healthy and nonhealthy subjects, respectively.Discussion.This study partially supports the possible effect of acupuncture in modulating the LF of HRV in both healthy and nonhealthy subjects, while previous review reported that acupuncture did not have any convincing effect on HRV in healthy subjects. More published work is needed in this area to determine if HRV can be an indicator of the therapeutic effect of acupuncture.


Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 436-444 ◽  
Author(s):  
A R Poliwczak ◽  
E Waszczykowska ◽  
B Dziankowska-Bartkowiak ◽  
M Koziróg ◽  
K Dworniak

Background Systemic lupus erythematosus is a progressive autoimmune disease. There are reports suggesting that patients even without overt signs of cardiovascular complications have impaired autonomic function. The aim of this study was to assess autonomic function using heart rate turbulence and heart rate variability parameters indicated in 24-hour ECG Holter monitoring. Methods Twenty-six women with systemic lupus erythematosus and 30 healthy women were included. Twenty-four hour ambulatory ECG-Holter was performed in home conditions. The basic parameters of heart rate turbulence and heart rate variability were calculated. The analyses were performed for the entire day and separately for daytime activity and night time rest. Results There were no statistically significant differences in the basic anthropometric parameters. The mean duration of disease was 11.52 ± 7.42. There was a statistically significant higher turbulence onset (To) value in patients with systemic lupus erythematosus, median To = –0.17% (minimum –1.47, maximum 3.0) versus To = –1.36% (minimum –4.53, maximum –0.41), P < 0.001. There were no such differences for turbulence slope (Ts). In the 24-hour analysis almost all heart rate variability parameters were significantly lower in the systemic lupus erythematosus group than in the healthy controls, including SDANN and r-MSSD and p50NN. Concerning the morning activity and night resting periods, the results were similar as for the whole day. In the control group, higher values in morning activity were noted for parameters that characterise sympathetic activity, especially SDANN, and were significantly lower for parasympathetic parameters, including r-MSSD and p50NN, which prevailed at night. There were no statistically significant changes for systemic lupus erythematosus patients for p50NN and low and very low frequency. There was a positive correlation between disease duration and SDNN, R = 0.417; P < 0.05 and SDANN, R = 0.464; P < 0.05, a negative correlation between low/high frequency ratio and r-MSSD, R = –0.454; P < 0.05; p50NN, R = –0.435; P < 0.05 and high frequency, R = –0.478; P < 0.05. In contrast, there was no statistically significant correlation between heart rate turbulence and other variables evaluated, including disease duration and the type of autoantibodies. Conclusion: Our study confirms the presence of autonomic disorders with respect to both heart rate variability and heart rate turbulence parameters and the presence of diurnal disturbances of sympathetic–parasympathetic balance. Further studies are required.


2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Sri Rahayu

Abtrak. Anemia merupakan masalah kesehatan masyarakat secara global baik dinegara berkembang maupun negara maju. Anemia terjadi pada semua tahap siklus kehidupan, umumnya terjadi pada masa anak-anak dan wanita hamil (WHO, 2008). Di puskesmas Pegandon Kabupaten Kendal pada bulan Agustus 2017 didapatkan ibu hamil dengan kadar HB 8,2 gr% mengalami perdarahan pada saat melahirkan. Penelitian ini bertujuan mengevaluasi pemberian tablet FEpada ibu nifas.Desain penelitian menggunakanmatching pretest-post test control group design. Penelitian ini menggunakan data kohort dari ibu hamil  di puskesmas Pegandon yang melahirkan pada bulan Desember 2017 – Januari 2018. Sampelnya ibu nifas pada bulan  Januari – Maret 2018yang datang di puskesmas Pegandon untuk melahirkan sebanyak 72 ibu nifas. Hasil penelitian menunjukkan sebagian besar  pada responden perlakuan mempunyai usia reproduksi 30 (83,3%),  sebagian berpendidikan (SD danSMP) 28 (77.8%) dan berpenghasilan sesuai UMK 22 (61.1%) sedangkan pada responden control untuk usia reproduksi25 (69%), berpendidikan (SD dan SMP) 31 (86%) dan berpenghasilan sesuai UMK 15 (41.7%).Pada analisis bivariate dengan uji kolmogorov-smirnov didapatkan p> 0.00 pada perlakuan dan kontrol. Disimpulkan bahwa diberikan dan tidak diberikan tablet FE pada ibu nifas didapatkan hasil sama berpengaruh dalam peningkatan kadar HB.Disarankansetiap ibu nifas meminum tablet FE supaya tidak terjadi anemia dan memberikan ASI pada bayinya dengan maksimal.Kata kunci : anemia, ibu nifas, tablet FE The Influence Of Iron Tablets In Pifandon Mother To Post Partum Anemia In Pegandon Community Health Center Area Abtract.Anemia is a global public health problem both in developing and developed countries. Anemia occurs at all stages of the life cycle, generally occurring during childhood and pregnant women (WHO, 2008). In Pegandon Puskesmas Kendal Regency in August 2017 it was found that pregnant women with HB levels 8.2 gr% had bleeding at the time of delivery. This study aims to evaluate the administration of FE tablets to postpartum mothers. The study design used a matching pretest-post test control group design. This study uses cohort data from pregnant women at the Pegandon puskesmas who gave birth in December 2017 - January 2018. The sample was postpartum mothers in January - March 2018 who came to the Pegandon puskesmas to deliver 72 postpartum mothers. The results showed that most of the treatment respondents had a reproductive age of 30 (83.3%), some were educated (SD and SMP) 28 (77.8%) and earning according to MSE was 22 (61.1%) while the control respondents were for reproductive age 25 (69% ), educated (elementary and junior high) 31 (86%) and earning according to UMK 15 (41.7%). In the bivariate analysis with the Kolmogorov-Smirnov test, p> 0.00 was obtained for treatment and control. It was concluded that given and not given FE tablets to the puerperal mothers found the same effect had an effect on increasing HB levels. It is recommended that every puerperal woman take FE tablets so that anemia does not occur and give milk to her baby to the maximum..Keywords: anemia, puerperal mothers, FE tablets


2021 ◽  
pp. 10-15
Author(s):  
Volodymyr I. Chermak ◽  
Ihor I. Chermak ◽  
Chukwuanyinonso O. Ikeotuonye ◽  
Anatolii Ya. Senchuk

To study morphological features of the placenta in women in labor, pregnancy which complicated by preeclampsia we studied 26 placentae, of which 17 were from pregnant women with mild to moderate preeclampsia (basic group) and 9 from healthy women (control group). Histologically the study was conducted with methodically recommendations of T.D. Zadorozhnaya et al. for light microscopy. During the study of morphological features of the placenta in women in labor with preeclampsia were installed morphological changes in the placenta, which reflect a tendency to develop compensatory-adaptive reactions following their stress and exhaustion, which is a sign of placental insufficiency. Received data allow claiming a high frequency of development placental insufficiency in pregnant women with risk factors such as chronic salpingo-oophoritis, anemia, late preeclampsia, and inflammation diseases kidney.


2019 ◽  
Vol 18 (8) ◽  
pp. 658-666 ◽  
Author(s):  
Ching-Hsiang Chen ◽  
Kuo-Sheng Hung ◽  
Yu-Chu Chung ◽  
Mei-Ling Yeh

Background: Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. Objectives: This study was designed to evaluate the effect of a mind–body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. Methods: A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind–body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). Results: The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 ( p<0.05) than the control group. Among the covariates, neurologic deficit ( p=0.04), muscle strength ( p=0.04), low frequency to high frequency ratio ( p=0.02) and anxiety ( p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life ( p >0.05). Conclusions: This study supports the potential benefits of a 10-day mind–body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.


Author(s):  
Nidhi Pandey ◽  
Poonam Goel ◽  
Anita Malhotra ◽  
Reeti Mehra ◽  
Navjot Kaur

Background: The objective of the study was to assess vascular function in normal pregnant women and women with gestational diabetes and to study its temporal relationship with gestational age at 24-28-week POG and at 36-38-week POG and changes in FMD in postpartum period.Methods: Assessment of vascular function was done at 24-28-week POG, 36-38-week POG and at 6-12-week postpartum by flow mediated dilation of brachial artery in 37 healthy pregnant women and 37 pregnant women with GDM.Results: In GDM group mean FMD at 24-28 weeks of POG, at 36-38 weeks POG was lower as compared to the control group (11.225±6.20,8.464±6.09 versus 14.49±5.21, 10.898±4.12) although the difference in mean FMD in two groups was not statistically significant. It was found that the decrease in FMD at 36-38-week POG as compared to 24-28 weeks POG was statistically significant in both the groups (p<0.001).Conclusions: This study revealed that when endothelial function as assessed by FMD was compared at different period of gestation, the mean decrease in FMD at 36-38-week POG as compared to 24-28-week POG and 6-week post-partum was statistically significant in patients with GDM and as well as the control group, however this trend of change was same in both the groups and was not statistically significant when compared between the two group (GDM versus control). A negative correlation of FMD was found with BMI, and HBA1c, that was stronger in GDM group.


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