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Cardiac output; obstetric

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https://www.readbyqxmd.com/read/27705969/non-invasive-haemodynamic-monitoring-in-pregnancy-a-comparative-study-using-ultrasound-and-bioreactance
#1
Dimuthu Vinayagam, Sophie Bowe, Elaine Sheehan, Basky Thilaganathan, Asma Khalil
BACKGROUND: Due to the importance of cardiovascular dysfunction and advances in the development and use of non-invasive cardiac output (CO) monitoring devices, there is a growing interest in their use in the obstetric population. The aim of this study was to compare two commercially available, non-invasive CO monitors in the assessment of heart rate (HR), stroke volume (SV), CO, cardiac index (CI) and total peripheral resistance (TPR) in an obstetric population. METHODS: This was a prospective, comparative study including two groups...
October 6, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27680795/c4-maternal-cardiac-changes-during-uncomplicated-twin-pregnancy-does-the-chorionicity-matter
#2
T Ghi, L Franchi, S Fieni, A Dall'Asta, N Gaibazzi, C Siniscalchi, G Pedrazzi, E Sciatti, I Bonadei, E Vizzardi, E Montaguti, D Degli Esposti, C Borghi, R Orabona, F Prefumo, T Frusca
OBJECTIVES: To assess longitudinally the echocardiographic findings in a cohort of women carrying an uncomplicated monochorionic (MC) twin pregnancy and compare them with those obtained from dichorionic (DC) twin gestations. METHODS: Healthy women with MC twin pregnancies were submitted to serial transthoracic maternal echocardiography during the first, second and third trimester. Cases with severe obstetric complications after enrollment were eventually excluded...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27671837/maternal-cardiovascular-function-at-35-37-weeks-gestation-relation-to-maternal-characteristics
#3
Gavin P Guy, Hua Z Ling, Paula Garcia, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. METHODS: In 3,013 singleton pregnancies at 35-37 weeks maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters amongst gestational age (GA), maternal characteristics and medical history...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27491768/echocardiography-in-pregnancy-part-1
#4
REVIEW
Shuang Liu, Uri Elkayam, Tasneem Z Naqvi
Cardiovascular disease (CVD) remains the leading cause of maternal mortality, and clinical diagnosis of CVD in women during pregnancy is challenging. Pregnant women with known heart disease require careful multidisciplinary management by obstetric and medical teams to assess for maternal and fetal risk. Echocardiography is a safe and effective diagnostic tool indicated in pregnant women with cardiac symptoms or women with known cardiac disease for appropriate selection of women who require close monitoring of cardiac condition and valvular function...
September 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27393077/cardiovascular-emergencies-and-cardiac-arrest-in-a-pregnant-woman
#5
Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard
No abstract text is available yet for this article.
July 5, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27184441/massive-obstetric-hemorrhage-current-approach-to-management
#6
E Guasch, F Gilsanz
Massive obstetric hemorrhage is a major cause of maternal mortality and morbidity worldwide. It is defined (among others) as the loss of>2,500ml of blood, and is associated to a need for admission to critical care and/or hysterectomy. The relative hemodilution and high cardiac output found in normal pregnancy allows substantial bleeding before a drop in hemoglobin and/or hematocrit can be identified. Some comorbidities associated with pregnancy can contribute to the occurrence of catastrophic bleeding with consumption coagulopathy, which makes the situation even worse...
June 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/26597153/maternal-cardiac-output-and-fetal-doppler-predict-adverse-neonatal-outcomes-in-pregnant-women-with-heart-disease
#7
Rachel M Wald, Candice K Silversides, John Kingdom, Ants Toi, Cathy S Lau, Jennifer Mason, Jack M Colman, Mathew Sermer, Samuel C Siu
BACKGROUND: The mechanistic basis of the proposed relationship between maternal cardiac output and neonatal complications in pregnant women with heart disease has not been well elucidated. METHODS AND RESULTS: Pregnant women with cardiac disease and healthy pregnant women (controls) were prospectively followed with maternal echocardiography and obstetrical ultrasound scans at baseline, third trimester, and postpartum. Fetal/neonatal complications (death, small-for-gestational-age or low birthweight, prematurity, respiratory distress syndrome, or intraventricular hemorrhage) comprised the primary study outcome...
November 23, 2015: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#8
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/25915203/the-role-of-cardiac-output-monitoring-in-obstetric-anesthesia
#9
REVIEW
Eldrid Langesæter, Matthew Gibbs, Robert A Dyer
PURPOSE OF REVIEW: Haemodynamic monitoring in obstetric patients has evolved during the last decade, with the development of minimally invasive and noninvasive continuous cardiac output (CO) monitors. This review focuses on recent articles that improve our understanding of physiology and haemodynamic changes during spinal anaesthesia in healthy pregnant women, and pathophysiology in women with preeclampsia and other cardiovascular disease. RECENT FINDINGS: Recent research findings in healthy women focus on the haemodynamic changes due to aortocaval compression, fluid administration, vasopressor therapy, and oxytocin during spinal anaesthesia for caesarean delivery...
June 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25812006/transthoracic-echocardiography-in-women-with-preeclampsia
#10
Alicia T Dennis
PURPOSE OF REVIEW: Recent literature on the role of transthoracic echocardiography in the management of women with preeclampsia is reviewed with emphasis on recommendations for its use in the life-threatening complications of acute pulmonary edema, chest pain, and hemorrhage. RECENT FINDINGS: The diagnostic criteria for preeclampsia are closer to reaching international consensus with most guidelines now removing the mandatory requirement for proteinuria. Hemodynamic findings using transthoracic echocardiography in women with untreated preeclampsia include normal or increased cardiac output, normal or increased contractility, a nondilated left ventricle, diastolic dysfunction, increased pericardial effusions, and increased left ventricular mass...
June 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25721057/hemodynamic-effects-of-intravenous-nicardipine-in-severely-pre-eclamptic-women-with-a-hypertensive-crisis
#11
J Cornette, E A B Buijs, J J Duvekot, E Herzog, J W Roos-Hesselink, D Rizopoulos, M Meima, E A P Steegers
OBJECTIVE: Nicardipine permits rapid control of blood pressure in women with severe pre-eclampsia (PE) and hypertensive crisis. Our objective was to investigate its maternal and fetal hemodynamic effects. METHODS: Ten severely pre-eclamptic pregnant women who required intravenous nicardipine for severe hypertension were included in this prospective observational trial. Maternal macrocirculation was assessed by transthoracic echocardiography. Maternal microcirculatory perfusion was examined sublingually with the sidestream dark field imaging technique...
January 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/25635593/randomized-double-blinded-comparison-of-norepinephrine-and-phenylephrine-for-maintenance-of-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery
#12
RANDOMIZED CONTROLLED TRIAL
Warwick D Ngan Kee, Shara W Y Lee, Floria F Ng, Perpetua E Tan, Kim S Khaw
BACKGROUND: During spinal anesthesia for cesarean delivery, phenylephrine can cause reflexive decreases in maternal heart rate and cardiac output. Norepinephrine has weak β-adrenergic receptor agonist activity in addition to potent α-adrenergic receptor activity and therefore may be suitable for maintaining blood pressure with less negative effects on heart rate and cardiac output compared with phenylephrine. METHODS: In a randomized, double-blinded study, 104 healthy patients having cesarean delivery under spinal anesthesia were randomized to have systolic blood pressure maintained with a computer-controlled infusion of norepinephrine 5 μg/ml or phenylephrine 100 μg/ml...
April 2015: Anesthesiology
https://www.readbyqxmd.com/read/25195565/giant-chorioangiomas-perinatal-outcomes-and-techniques-in-fetoscopic-devascularization
#13
Foong-Yen Lim, Alan Coleman, William Polzin, Ronald Jaekle, Mounira Habli, James Van Hook, David Lewis, Timothy Crombleholme
OBJECTIVE: To evaluate the intrauterine management and perinatal outcome of pregnancies complicated by giant placental chorioangioma (>4 cm) and elaborate on various devascularization techniques. MATERIALS AND METHODS: Retrospective review of 10 cases of giant placental chorioangioma evaluated between January 2005 and August 2012. Maternal demographics, prenatal imaging, response to fetoscopic treatment, obstetrical complications, and perinatal outcomes were evaluated...
2015: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/25072763/cerebral-oximetry-assessed-by-near-infrared-spectrometry-during-preeclampsia-an-observational-study-impact-of-magnesium-sulfate-administration
#14
COMPARATIVE STUDY
Philippe Guerci, Florence Vial, Jérôme Feugeas, Marius Pop, Nour-Eddine Baka, Hervé Bouaziz, Marie-Reine Losser
OBJECTIVES: To determine the regional cerebral oxygen saturation of hemoglobin (rcSO2) in severe preeclamptic parturients exhibiting neurologic symptoms compared with healthy pregnant women (control) and to describe the effects of MgSO4 infusion on rcSO2 and cerebral and systemic hemodynamic variables. DESIGN: Prospective, observational study. SETTING: Obstetric critical care unit in a university-affiliated hospital. PATIENTS: Twenty severe preeclamptic parturients presenting with neurologic signs before any administration of MgSO4, and 20 control parturients...
November 2014: Critical Care Medicine
https://www.readbyqxmd.com/read/24753937/the-maternal-venous-system-the-ugly-duckling-of-obstetrics
#15
K Tomsin
In pregnancy, both maternal vascular tone and cardiac function are considered key players to reach a normal outcome for both mother and child. This complex story of maternal hemodynamics is intensely discussed in current scientific literature, however the role of the maternal veins has been strongly underestimated. We developed and evaluated a set of measurable objective parameters which give an indication of venous function, i.e. the venous impedance index and the venous pulse transit time. These parameters turned out to be subject to changes throughout normal pregnancy and in preeclampsia enabling their use in gestational hemodynamic -studies...
2013: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/24315699/transoesophageal-doppler-guided-fluid-management-in-massive-obstetric-haemorrhage
#16
R Schiraldi, L Calderón, G Maggi, N Brogly, E Guasch, F Gilsanz
Massive postpartum haemorrhage is a major worldwide cause of maternal mortality. Management requires intensive fluid resuscitation and blood transfusion. Although fluid therapy is often directed by the results of a full blood count and clotting screen, recent technological advances allow monitoring of haemodynamic function and cardiac output. Transoesophageal Doppler technology has been used during haemorrhagic shock in non-obstetric patients. We present the case of a caesarean delivery complicated by massive haemorrhage where transoesophageal Doppler monitoring with the CardioQ-ODM™ was used to guide fluid therapy and the use of vasoactive drugs...
February 2014: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/24300387/cardiac-output-monitoring-in-obstetric-anaesthesia
#17
EDITORIAL
A T Dennis, R A Dyer
No abstract text is available yet for this article.
February 2014: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/24280470/acute-improvement-in-hemodynamic-control-after-osteopathic-manipulative-treatment-in-the-third-trimester-of-pregnancy
#18
RANDOMIZED CONTROLLED TRIAL
Kendi L Hensel, Christina F Pacchia, Michael L Smith
OBJECTIVES: The physiological changes that occur during pregnancy, including increased blood volume and cardiac output, can affect hemodynamic control, most profoundly with positional changes that affect venous return to the heart. By using Osteopathic Manipulative Treatment (OMT), a body-based modality theorized to affect somatic structures related to nervous and circulatory systems, we hypothesized that OMT acutely improves both autonomic and hemodynamic control during head-up tilt and heel raise in women at 30 weeks gestation...
December 2013: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/24247986/xanthine-oxidase-and-the-fetal-cardiovascular-defence-to-hypoxia-in-late-gestation-ovine-pregnancy
#19
Andrew D Kane, Jeremy A Hansell, Emilio A Herrera, Beth J Allison, Youguo Niu, Kirsty L Brain, Joepe J Kaandorp, Jan B Derks, Dino A Giussani
Hypoxia is a common challenge to the fetus, promoting a physiological defence to redistribute blood flow towards the brain and away from peripheral circulations. During acute hypoxia, reactive oxygen species (ROS) interact with nitric oxide (NO) to provide an oxidant tone. This contributes to the mechanisms redistributing the fetal cardiac output, although the source of ROS is unknown. Here, we investigated whether ROS derived from xanthine oxidase (XO) contribute to the fetal peripheral vasoconstrictor response to hypoxia via interaction with NO-dependent mechanisms...
February 1, 2014: Journal of Physiology
https://www.readbyqxmd.com/read/24195460/non-invasive-assessment-of-gestational-hemodynamics-benefits-and-limitations-of-impedance-cardiography-versus-other-techniques
#20
REVIEW
Anneleen Staelens, Kathleen Tomsin, Lars Grieten, Jolien Oben, Tinne Mesens, Marc Spaanderman, Yves Jacquemyn, Wilfried Gyselaers
To obtain data for maternal stroke volume and cardiac output during pregnancy, it is preferable to use a non-invasive, accurate and reproducible method. In this aspect, impedance cardiography is an excellent technique which is also highly accessible and easy to perform. This paper is a comprehensive review on the published literature about impedance cardiography and highlights the strengths and limitations of its applications in obstetrics.
November 2013: Expert Review of Medical Devices
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