scholarly journals New Insights into Vaginal Environment During Pregnancy

2021 ◽  
Vol 8 ◽  
Author(s):  
Antonella Marangoni ◽  
Luca Laghi ◽  
Sara Zagonari ◽  
Giulia Patuelli ◽  
Chenglin Zhu ◽  
...  
Keyword(s):  
First Trimester ◽  
Normal Pregnancy ◽  
Metabolic Profiles ◽  
Third Trimester ◽  
Bacterial Composition ◽  
Nugent Score ◽  
H Nmr ◽  
Significant Enrichment ◽  
Novel Biomarkers ◽  
Caucasian Women

During pregnancy, the vaginal ecosystem undergoes marked changes, including a significant enrichment with Lactobacillus spp. and profound alterations in metabolic profiles. A deep comprehension of the vaginal environment may shed light on the physiology of pregnancy and may provide novel biomarkers to identify subjects at risk of complications (e.g., miscarriage, preterm birth). In this study, we characterized the vaginal ecosystem in Caucasian women with a normal pregnancy (n = 64) at three different gestational ages (i.e., first, second and third trimester) and in subjects (n = 10) suffering a spontaneous first trimester miscarriage. We assessed the vaginal bacterial composition (Nugent score), the vaginal metabolic profiles (1H-NMR spectroscopy) and the vaginal levels of two cytokines (IL-6 and IL-8). Throughout pregnancy, the vaginal microbiota became less diverse, being mainly dominated by lactobacilli. This shift was clearly associated with marked changes in the vaginal metabolome: over the weeks, a progressive reduction in the levels of dysbiosis-associated metabolites (e.g., biogenic amines, alcohols, propionate, acetate) was observed. At the same time, several metabolites, typically found in healthy vaginal conditions, reached the highest concentrations at the end of pregnancy (e.g., lactate, glycine, phenylalanine, leucine, isoleucine). Lower levels of glucose were an additional fingerprint of a normal vaginal environment. The vaginal levels of IL-6 and IL-8 were significantly associated with the number of vaginal leukocytes, as well as with the presence of vaginal symptoms, but not with a condition of dysbiosis. Moreover, IL-8 concentration seemed to be a good predictor of the presence of vaginal Candida spp. Cytokine concentrations were negatively correlated to lactate, serine, and glycine concentrations, whereas the levels of 4-hydroxyphenyllactate, glucose, O-acetylcholine, and choline were positively correlated with Candida vaginal loads. Finally, we found that most cases of spontaneous abortion were associated with an abnormal vaginal microbiome, with higher levels of selected metabolites in the vaginal environment (e.g., inosine, fumarate, xanthine, benzoate, ascorbate). No association with higher pro-inflammatory cytokines was found. In conclusion, our analysis provides new insights into the pathophysiology of pregnancy and highlights potential biomarkers to enable the diagnosis of early pregnancy loss.

scholarly journals Pre-Pregnancy Diet and Vaginal Environment in Caucasian Pregnant Women: An Exploratory Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Margherita Dall’Asta ◽  
Luca Laghi ◽  
Sara Morselli ◽  
Maria Carla Re ◽  
Sara Zagonari ◽  
...  
Keyword(s):  
Protective Factor ◽  
First Trimester ◽  
Local Immunity ◽  
Bacterial Composition ◽  
H Nmr ◽  
Metabolic Products ◽  
Dietary Nutrient ◽  
Total Carbohydrates ◽  
Vaginal Health ◽  
Caucasian Women

Vaginal microbes and their metabolic products have crucial functions, affecting local immunity development and maternal-fetal health. The composition of the vaginal microbiome can vary in response to various factors, including body mass index (BMI), and diet. In this study we get new insights into the vaginal ecosystem of Caucasian women (n = 24) at the first trimester of pregnancy, assessing whether pre-pregnancy diet can affect the structure of the vaginal environment in terms of bacterial composition and vaginal metabolite concentration. We characterized 1) the vaginal bacterial composition (Nugent score), 2) the vaginal metabolic profiles (1H-NMR spectroscopy), and 3) the dietary nutrient intake by means of a validated food frequency questionnaire. Pre-pregnancy BMI was negatively related to vaginal health status, indicating that women who begin pregnancy overweight/obese have a greater occurrence of vaginal dysbiosis during pregnancy. A lactobacilli-dominated vaginal microbiota was negatively associated with higher pre-pregnancy intake of animal-sourced protein. Conversely, a higher pre-pregnancy consumption of total carbohydrates and sugars seemed to be a protective factor for vaginal health. The vaginal environment of BV-women was characterized by higher levels of biogenic amines and organic acids, whereas higher levels of phenylpropionate and diverse amino acids were fingerprints of a healthy vaginal status. A significant association between a higher pre-pregnancy BMI and several dysbiosis-related vaginal metabolites was also found. Our study shed light on the role of pre-pregnancy BMI and diet on the vaginal environment during pregnancy, underlining the importance of limiting protein intake from animal foods to maintain a healthy lactobacilli-dominated microbiota.

scholarly journals Thrombin Generation in Chinese Pregnant Women and the Effect of Insulin Use on Thrombin Generation in Patients with GDM

2019 ◽  
Vol 25 ◽  
pp. 107602961986349
Author(s):  
Feng Dong ◽  
Longhao Wang ◽  
Chengbin Wang
Keyword(s):  
Blood Glucose ◽  
Pregnant Women ◽  
Thrombin Generation ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
Control Blood Glucose ◽  
Normal Ranges ◽  
Increased Risk ◽  
Significant Difference

Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis. Calibrated automated thrombogram (CAT) is a test to monitor the thrombin generation (TG), a laboratory marker of thrombosis risk, and increases during normal pregnancy, but it is still unclear whether TG is related to the use of insulin in pregnant women with gestational diabetes mellitus (GDM). We performed thrombin generation by CAT on 135 normal pregnant women, including 43 in first trimester, 32 in second trimester, 60 in third trimester, respectively; 68 pregnant women with GDM were also enrolled, 19 patients with GDM using insulin to control blood glucose and 49 patients control their blood glucose through diet and exercise with noninsulin treatment. The overall CAT parameters were calculated using descriptive statistics method with mean ± standard deviation. Mean endogenous thrombin potential, peak thrombin generation, and StartTail time increased significantly with the pregnancy. There was no significant difference in TG test parameters except StartTail time( P = .003) in insulin-treated GDM group when compared to those without insulin in the GDM group. The normal ranges for CAT parameters in pregnant women were determined. Thrombin generation increased significantly in first trimester and remains stable in second and third trimester. The use of insulin in patient with GDM did not affect thrombin generation test. Our study helps to establish the reference range of thrombin generation in Chinese normal pregnant population and provide more basis to predict the risk of thrombus complicating during pregnancy.

scholarly journals Metalloprotease Dependent Release of Placenta Derived Fractalkine

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Monika Siwetz ◽  
Astrid Blaschitz ◽  
Julia Kremshofer ◽  
Jelena Bilic ◽  
Gernot Desoye ◽  
...  
Keyword(s):  
Inflammatory Responses ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Low Grade ◽  
Third Trimester ◽  
Maternal Circulation ◽  
Membrane Bound ◽  
Metalloprotease Activity ◽  
Metalloprotease Inhibitor ◽  
Trophoblast Cell Line

The chemokine fractalkine is considered as unique since it exists both as membrane-bound adhesion molecule and as shed soluble chemoattractant. Here the hypothesis was tested whether placental fractalkine can be shed and released into the maternal circulation. Immunohistochemical staining of human first trimester and term placenta sections localized fractalkine at the apical microvillous plasma membrane of the syncytiotrophoblast. Gene expression analysis revealed abundant upregulation in placental fractalkine at term, compared to first trimester. Fractalkine expression and release were detected in the trophoblast cell line BeWo, in primary term trophoblasts and placental explants. Incubation of BeWo cells and placental explants with metalloprotease inhibitor Batimastat inhibited the release of soluble fractalkine and at the same time increased the membrane-bound form. These results demonstrate that human placenta is a source for fractalkine, which is expressed in the syncytiotrophoblast and can be released into the maternal circulation by constitutive metalloprotease dependent shedding. Increased expression and release of placental fractalkine may contribute to low grade systemic inflammatory responses in third trimester of normal pregnancy. Aberrant placental metalloprotease activity may not only affect the release of placenta derived fractalkine but may at the same time affect the abundance of the membrane-bound form of the chemokine.

scholarly journals Vaginal metabolic profiles during pregnancy: Changes between first and second trimester

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249925
Author(s):  
Luca Laghi ◽  
Sara Zagonari ◽  
Giulia Patuelli ◽  
Chenglin Zhu ◽  
Claudio Foschi ◽  
...  
Keyword(s):  
First Trimester ◽  
Vaginal Swab ◽  
Metabolic Profiles ◽  
Vaginal Microbiome ◽  
Second Trimester ◽  
Microbial Composition ◽  
Isoleucine Leucine ◽  
H Nmr ◽  
Microscopic Evaluation

During pregnancy, the vaginal microbiome plays an important role in both maternal and neonatal health outcomes. Throughout pregnancy, the vaginal microbial composition undergoes significant changes, including a decrease in overall diversity and enrichment with Lactobacillus spp. In turn, the modifications in the microbial profiles are associated with shifts in the composition of vaginal metabolites. In this study, we characterized the vaginal metabolic profiles throughout pregnancy at two different gestational ages, correlating them with a microscopic evaluation of the vaginal bacterial composition. A total of 67 Caucasian pregnant women presenting to the Family Advisory Health Centres of Ravenna (Italy) were enrolled and a vaginal swab was collected at gestational ages 9–13 weeks (first trimester) and 20–24 weeks (second trimester). The composition of the vaginal microbiome was assessed by Nugent score and women were divided in ‘H’ (normal lactobacilli-dominated microbiota), ‘I’ (intermediate microbiota), and ‘BV’ (bacterial vaginosis) groups. Starting from the cell-free supernatants of the vaginal swabs, a metabolomic analysis was performed by means of a 1H-NMR spectroscopy. From the first to the second trimester, a greater number of women showed a normal lactobacilli-dominated microbiota, with a reduction of cases of dysbiosis. These microbial shifts were associated with profound changes in the vaginal metabolic profiles. Over the weeks, a significant reduction in the levels of BV-associated metabolites (e.g. acetate, propionate, tyramine, methylamine, putrescine) was observed. At the same time, the vaginal metabolome was characterized by higher concentrations of lactate and of several amino acids (e.g. tryptophan, threonine, isoleucine, leucine), typically found in healthy vaginal conditions. Over time, the vaginal metabolome became less diverse and more homogeneous: in the second trimester, women with BV showed metabolic profiles more similar to the healthy/intermediate groups, compared to the first trimester. Our data could help unravel the role of vaginal metabolites in the pathophysiology of pregnancy.

scholarly journals Blunted erythropoietin production and decreased erythropoiesis in early pregnancy [see comments]

Blood ◽  
1991 ◽  
Vol 78 (1) ◽  
pp. 89-93
Author(s):  
Y Beguin ◽  
G Lipscei ◽  
H Thoumsin ◽  
G Fillet
Keyword(s):  
Early Pregnancy ◽  
Cell Mass ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Entire Group ◽  
Third Trimester ◽  
Serum Transferrin Receptor ◽  
Erythropoietin Production ◽  
Early Postpartum ◽  
First Trimester Of Pregnancy

After decreasing in the first trimester of pregnancy, the total red blood cell mass increases in the second and third trimesters to peak at term at about 120% to 125% of nonpregnant values, but how this is brought about by changes in the rate of erythropoiesis is not known. We evaluated erythropoiesis by measuring serum transferrin receptor (TfR) levels in 406 women during normal pregnancy (N = 317), at delivery (N = 63), or in the early postpartum (N = 27). Despite the presence of the placenta and the frequent occurrence of iron deficiency, TfR levels remained low in the first two trimesters and increased in the third trimester and at delivery. To explain why erythropoiesic activity was relatively low in early pregnancy, we also measured serum immunoreactive erythropoietin (Epo) in relation to the degree of anemia. There was a very strong correlation between serum TfR and Epo levels in the entire group (r = .59, P less than .0001) as well as in each period of pregnancy. Epo levels remained low for the degree of anemia and did not correlate with hematocrit in the first two trimesters, but recovered afterwards. In the early postpartum, Epo production and erythropoiesis were normal. We conclude that: (1) erythropoiesis is decreased in the first part of pregnancy but increases afterwards; and (2) blunted Epo production in early pregnancy could be responsible for that observation.

Severe Reduction of Free ADAMTS13, Unbound to Von Willebrand Factor, in Plasma Milieu Is a Unique Feature of HELLP Syndrome

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 134-134
Author(s):  
Yoko Yoshida ◽  
Ayami Isonishi ◽  
Toshiyuki Sado ◽  
Masaki Hayakawa ◽  
Hideo Yagi ◽  
...  
Keyword(s):  
Shear Stress ◽  
Pregnant Women ◽  
Hellp Syndrome ◽  
First Trimester ◽  
Normal Pregnancy ◽  
High Shear ◽  
High Shear Stress ◽  
Third Trimester ◽  
Severe Reduction ◽  
Mild Reduction

Abstract Introduction Plasma ADAMTS13 exists at least two forms, bound and unbound to vonWillebrandfactor (VWF), of which the former was assumed to be 3% of the total by the immunoprecipitation method (Feyset al., JTH 2009). We have shown that plasma ADAMTS13 consists of 3 group bands, by means of isoelectric focusing (IEF) analysis (Hori et al, Transfusion 2013). Band I (pI4.9-5.6) was assumed to be free ADAMTS13, unbound to VWF, and Band III (pI7.0-7.5) was a complex with high-molecular-weight VWFmultimers(HMW-VWFM). However, the feature of Band II (pI5.8-6.7) was undetermined. HELLP (hemolysis, elevated liver enzymes and low platelet counts) syndrome is a life-threatening thromboembolic complication during pregnancy, and its pathogenesis is not determined. The curative therapy of HELLP syndrome is a termination of pregnancy. It was reported that plasma VWF antigen (VWF: Ag) was remarkably increased (215-422% of the normal) with a mild reduction of ADAMTS13 activity (ADAMTS13: AC) (12-43 % of the normal), but without qualitative analysis of ADAMTS13 antigen (Lattuadaet al.,Haematologica2003). We here analyzed plasma ADAMTS13 antigen in 9 patients with HELLP syndrome using the IEF gel, and revealed a unique picture of severe reduction of Band I (free ADAMTS13), unbound to VWF, that was not seen in plasmas from normal pregnancy. Patients and Methods One hundred twenty-nine normal pregnant women and 9 patients with HELLP syndrome were analyzed under approval by the ethics committees of Nara Medical University. All individuals gave written informed consent to the study. Diagnosis of HELLP syndrome was made by all the following laboratory abnormalities: characteristics peripheral blood smear, serum LDH >600 IU/L (or total bilirubin >1.2 mg/dL), AST >70 IU/L, and platelet counts < 100,000/mm3 (Sibai et al., Am JObstetGynecol 1993). Plasma level of ADAMTS13: AC was determined by chromogenic ADAMTS13-act-ELISA, and VWF: Ag was measured by a sandwich ELISA using a rabbit polyclonal anti-human VWF antibody. As reported previously (Hori et al., Transfusion 2013), the IEF was performed using a large-pore agarose-acrylamide composing gel followed by detection with anti-ADAMTS13 monoclonal antibody. Results In normal women, plasma levels of VWF: Agweremarkedly increased during pregnancy, and the values of third trimester (median 223%) were almost two times higher than those of first trimester (119%). Contrarily,plasma levels ofADAMTS13: AC were significantly decreased in second (68.4%) and third (66.2%) trimester compared with first trimester (84.3%, p<0.01 and p<0.001, respectively). Of note, a reduction in ADAMTS13: AC was significantly prolonged in postpartum period (50.2%, p<0.001), while increased VWF: Ag was rapidly recovered after delivery. Further, the IEF analysis of normal pregnant women showed that Band I was slightly decreased in accord with progression of pregnancy. In puerperium, there was no difference in ADAMTS13: AC between normal pregnant women and patients with HELLP syndrome. However, the values of VWF: Ag of patients with HELLP syndrome (352%) were significantly higher than those of normal pregnant women (178%, p<0.001), in agreement with a previous report. Interestingly, however, here we have shown that 7 out of 9 patients with HELLP syndrome showed severe reduction of Band I in puerperium period by the IEF analysis of ADAMTS13 (Figure). Discussion In normal pregnant women, the decreased ADAMTS13:AC was assumed to reflect a consumption of the enzyme for cleavage of increased VWF. Interestingly, both Band II and III were almost unchanged during normal pregnancy, but Band I slightly decreased in third trimester, concomitantly with a mild reduction of ADAMTS13:AC. In contrast, Band I was severely reduced during the acute phase of HELLP syndrome in 7 out of 9 patients. Our previous report indicated that under high-shear-stress Band I inhibited the VWF-dependent platelet aggregation in a dose-response manner from the initial phase, whereas Band III (+II) worked from the later phase. This result indicates that ADAMTS13 lacking Band I neither readily binds to VWF nor efficiently blocks the heightened high-shear-stress induced platelet aggregation generated by newly produced HMW-VWFM. Our data suggest that ADAMTS13 preparation might be used as a therapeutic option for the treatment of HELLP syndrome, before termination of pregnancy. Disclosures No relevant conflicts of interest to declare.

Urinary excretion of some proteins and enzymes during normal pregnancy.

1989 ◽  
Vol 35 (9) ◽  
pp. 1978-1980 ◽  
Author(s):  
C K Cheung ◽  
T Lao ◽  
R Swaminathan
Keyword(s):  
Urinary Excretion ◽  
Molecular Mass ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Tubular Reabsorption ◽  
Retinol Binding Protein ◽  
Third Trimester ◽  
Gamma Glutamyltransferase ◽  
The Third ◽  
Alanine Aminopeptidase

Abstract Total protein (TP), albumin (Alb), transferrin (TRF), retinol-binding protein (RPB), N-acetyl-beta-glucosaminidase (NAG), alanine aminopeptidase (AAP), gamma-glutamyltransferase (GGT), and creatinine (Cr) were measured in random (untimed) urine samples from 29 nonpregnant women and from pregnant subjects (11 in the first trimester, 34 in the second, and 37 in the third). The excretion of TP, Alb, TRF, NAG, and AAP (relative to creatinine) and the RBP concentration were all higher (P less than or equal to 0.05) in the second and third trimesters compared with values for the nonpregnant controls. The GGT/Cr ratio was significantly higher only in the third trimester. The increase in low-molecular-mass proteins and tubular enzymes suggests that at least part of the increase in Alb, TRF, and TP results from decreased tubular reabsorption. We conclude that excretion of both high- and low-molecular-mass proteins is increased during pregnancy.

Is normal pregnancy atherogenic?

1999 ◽  
Vol 96 (4) ◽  
pp. 421-425 ◽  
Author(s):  
U. MARTIN ◽  
C. DAVIES ◽  
S. HAYAVI ◽  
A. HARTLAND ◽  
F. DUNNE
Keyword(s):  
Serum Cholesterol ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Cholesterol Concentration ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Serum Cholesterol Concentration ◽  
Ldl Subfractions ◽  
Normal Gestation

Serum cholesterol, triacylglycerols and low-density lipoprotein (LDL) subfractions were determined in 120 primagravid women during normal gestation (40 in each trimester) and in 20 non-pregnant age-matched controls. LDL subfractions were determined by PAGE, and an LDL score was calculated. The higher the score, the smaller the subfractions. The objective of the study was to determine the effects of the hyperlipidaemia, high oestrogen concentrations and insulin resistance known to exist in normal pregnancy on LDL subfraction formation. Pregnant women had an increased mean serum cholesterol concentration [5.78 (S.D. 1.09) mmol/l] in the first trimester compared with the non-pregnant controls [5.11 (0.77) mmol/l; P< 0.01]. The serum cholesterol concentration increased progressively throughout gestation to a mean of 8.14 (1.39) mmol/l in the third trimester (P< 0.001 compared with the second trimester). Triacylglycerol concentrations in the first trimester were similar to those of controls, and there was a non-significant increase by the second trimester to 1.32 (0.44) mmol/l. However, by the third trimester the mean triacylglycerol concentration had doubled [2.58 (0.98) mmol/l; P< 0.001 compared with the first and second trimester]. During gestation the LDL score increased dramatically, from 1.17 (0.39) during the first trimester to 2.01 (0.37) in the second trimester (P< 0.001) to 2.73 (0.48) in the third trimester (P< 0.001 compared with the second trimester). Thus an atherogenic lipid profile develops during normal gestation. The significance of these changes remains unclear, but thay may have important implications for mother and foetus.

Plasma kisspeptin is raised in patients with gestational trophoblastic neoplasia and falls during treatment

2006 ◽  
Vol 291 (5) ◽  
pp. E878-E884 ◽  
Author(s):  
Waljit S. Dhillo ◽  
Philip Savage ◽  
Kevin G. Murphy ◽  
Owais B. Chaudhri ◽  
Michael Patterson ◽  
...  
Keyword(s):  
Reproductive Development ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Gestational Trophoblastic Neoplasia ◽  
Third Trimester ◽  
Blood Samples ◽  
Amino Acid Peptide ◽  
The Third ◽  
First Trimester Of Pregnancy ◽  
G Protein Coupled

Kisspeptin is a 54-amino acid peptide, encoded by the anti-metastasis gene KiSS-1, that activates G protein-coupled receptor 54 (GPR54). The kisspeptin-GPR54 system is critical to normal reproductive development. KiSS-1 gene expression is increased in the human placenta in normal and molar pregnancies. Circulating kisspeptin is dramatically increased in normal pregnancy, but levels in GTN have not previously been reported. The present study was designed to determine whether plasma kisspeptin levels are altered in patients with malignant GTN. Thirty-nine blood samples were taken from 11 patients with malignant GTN at presentation during and after chemotherapy. Blood was also sampled from nonpregnant and pregnant volunteers. Plasma kisspeptin IR and hCG concentrations were measured. Plasma kisspeptin IR concentration in nonpregnant ( n = 16) females was <2 pmol/l. Plasma kisspeptin IR in females was 803 ± 125 pmol/l in the first trimester of pregnancy ( n = 13), 2,483 ± 302 pmol/l in the third trimester of pregnancy ( n = 7), and <2 pmol/l on day 15 postpartum ( n = 7). Plasma kisspeptin IR and hCG concentrations in patients with malignant GTN were elevated at presentation and fell during and after treatment with chemotherapy in each patient (mean plasma kisspeptin IR: prechemotherapy 1,363 ± 1,076 pmol/l vs. post-chemotherapy <2 pmol/l, P < 0.0001; mean plasma hCG: prechemotherapy 227,191 ± 152,354 U/l vs. postchemotherapy 2 U/l, P < 0.0001). Plasma kisspeptin IR strongly positively correlated with plasma hCG levels ( r2= 0.99, P < 0.0001). Our results suggest that measurement of plasma kisspeptin IR may be a novel tumor marker in patients with malignant GTN.

scholarly journals Venous and arterial behavior during normal pregnancy

1998 ◽  
Vol 274 (5) ◽  
pp. H1605-H1612 ◽  
Author(s):  
D. A. Edouard ◽  
B. M. Pannier ◽  
G. M. London ◽  
J. L. Cuche ◽  
M. E. Safar
Keyword(s):  
Viscoelastic Properties ◽  
Aortic Distensibility ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Systemic Blood Pressure ◽  
Left Ventricular ◽  
Lower Limbs ◽  
Third Trimester ◽  
Venous Tone ◽  
The Third

To assess the contribution of the arterial and venous systems in the hemodynamic changes of normal pregnancy, we studied blood flow, vascular resistance, venous tone, and the viscoelastic properties (“creep”) of the upper and lower limbs (using plethysmography), aortic distensibility (using pulse wave velocity measurements), and cardiac dimensions (using echocardiography) in nine healthy women. Studies were longitudinally performed at the first (10–13 wk) and third (33–38 wk) trimesters of pregnancy in comparison with the period between the third and sixth month after delivery. From the first trimester, heart rate significantly increased while systemic blood pressure and limb vascular resistances did not change significantly and aortic distensibility increased ( P < 0.05). Lower limb viscoelastic properties decreased at the third trimester ( P < 0.05) and venous tone increased from the first trimester ( P < 0.01), whereas little changes were observed at the site of upper limbs. The decrease in calf venous tone was significantly correlated with the increase in left ventricular diastolic diameter at the first ( P < 0.001) and the third trimester ( P < 0.05). The study provides evidence that during normal pregnancy, changes in the arterial and venous sides of the circulation occur independently of pressure alterations. The increase in venous tone, contributing to preload augmentation, and the decrease in aortic stiffness, reducing afterload, both optimize cardiac function until delivery.

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