Kametas Nikos A, McAuliffe Fionnuala, Krampl Elisabeth, Chambers John, Nicolaides Kypros H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, United Kingdom.
Obstet Gynecol. 2003 Oct;102(4):806-15. doi: 10.1016/s0029-7844(03)00807-x.
To investigate maternal cardiac function in twin pregnancy.
We conducted a cross-sectional study of 119 pregnant women with twin pregnancies at 10-40 weeks' gestation. Two-dimensional and M-mode echocardiography of the left ventricle was performed in the left lateral decubitus position to assess left ventricular longitudinal and transverse systolic function. The measurements were compared with those obtained from 128 women with singleton pregnancies previously reported.
In twin pregnancies, compared with singletons, maternal cardiac output was greater by 20% (P <.001), because of a greater stroke volume (15%, P <.001) and heart rate (3.5%; P =.04). Furthermore, in women with twins there were greater left ventricular end-diastolic and left ventricular end-systolic dimensions, left ventricular mass (13.5%; P <.001), fractional shortening (3%; P =.04), and ejection fraction (2.5%; P =.04). Mean arterial pressure and global time to shortening in women with twins, compared with singletons, were less in the first trimester by approximately 2%, but after midpregnancy they increased progressively, so that at term the measurements were greater by 3% and 5.7%, respectively (P =.03). Conversely, long axis shortening in women with twins, compared with singletons, was greater in the first trimester by approximately 6.5%, but at term it was 3% less (P =.01). Twin pregnancies that subsequently developed preeclampsia had a hemodynamic profile similar to the rest of the twin population.
Twin pregnancy is characterized by an even more hyperdynamic circulation than singleton pregnancy. Left ventricle longitudinal systolic function and mean arterial pressure are more abruptly affected after 20 weeks compared with singleton pregnancies.
研究双胎妊娠孕妇的心脏功能。
我们对119例孕10 - 40周的双胎妊娠孕妇进行了横断面研究。在左侧卧位进行左心室二维和M型超声心动图检查，以评估左心室纵向和横向收缩功能。将测量结果与先前报道的128例单胎妊娠女性的测量结果进行比较。
在双胎妊娠中，与单胎妊娠相比，孕妇的心输出量增加20%（P <.001），这是由于每搏输出量增加15%（P <.001）和心率增加3.5%（P =.04）。此外，双胎妊娠女性的左心室舒张末期和收缩末期内径、左心室质量（13.5%；P <.001）、缩短分数（3%；P =.04）和射血分数（2.5%；P =.04）更大。与单胎妊娠女性相比，双胎妊娠女性的平均动脉压和整体缩短时间在孕早期减少约2%，但孕中期后逐渐增加，因此足月时测量值分别增加3%和5.7%（P =.03）。相反，与单胎妊娠女性相比，双胎妊娠女性的长轴缩短在孕早期增加约6.5%，但足月时减少3%（P =.01）。随后发生子痫前期的双胎妊娠的血流动力学特征与其他双胎人群相似。
双胎妊娠的特点是循环动力学比单胎妊娠更为亢进。与单胎妊娠相比，双胎妊娠在20周后左心室纵向收缩功能和平均动脉压受到的影响更为突然。
