Moertl Manfred G, Ulrich Daniela, Pickel Karoline I, Klaritsch Philipp, Schaffer Monika, Flotzinger Doris, Alkan Isa, Lang Uwe, Schlembach Dietmar
Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, A-8036 Graz, Austria.
Eur J Obstet Gynecol Reprod Biol. 2009 May;144 Suppl 1:S179-83. doi: 10.1016/j.ejogrb.2009.02.037. Epub 2009 Mar 13.
To examine non-invasively haemodynamic and autonomous parameters throughout normal pregnancy.
We used the Task Force Monitor 3040i system to retrieve, record, and calculate haemodynamic as well as autonomous parameters. 20 healthy women were included and scheduled for longitudinal examinations throughout normal pregnancy. Heart rate (HR), blood pressure (BP), stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR), heart rate variability (HRV), blood pressure variability (BPV), and baroreceptor sensitivity (BRS) were measured. Measurements were performed at gestational week 10(+0)-13(+6), 15(+0)-18(+6), 20(+0)-22(+6), and >30(+0).
HR increased during gestation showing a significant increase at III versus I trimester (74 bpm vs. 88 bpm, P<.05). Mean arterial pressure remained stable until III trimester, when a significant increase compared to I trimester could be noted (78 mm Hg vs. 86 mm Hg, P<.05). SV and CO remained relatively stable in I and II trimester, and in III trimester significant decreases were observed. In contrast, SVR increased significantly at III trimester (P<.001). Whereas HRV and BPV did not change at different gestational ages, BRS was significantly lower in III trimester compared to I trimester values (P<.05).
The non-invasive determination of cardiovascular and autonomous parameters throughout pregnancy is possible and the results of this pilot study can serve as basic parameters for classifying and assessing cardiovascular and autonomous changes in pathological conditions in pregnancy such as hypertensive disorders.
无创检测正常孕期的血流动力学和自主神经参数。
我们使用Task Force Monitor 3040i系统获取、记录并计算血流动力学及自主神经参数。纳入20名健康女性，计划在整个正常孕期进行纵向检查。测量心率（HR）、血压（BP）、每搏输出量（SV）、心输出量（CO）、全身血管阻力（SVR）、心率变异性（HRV）、血压变异性（BPV）和压力感受器敏感性（BRS）。测量在孕10（+0）-13（+6）周、15（+0）-18（+6）周、20（+0）-22（+6）周及>30（+0）周进行。
孕期HR增加，与孕早期相比，孕晚期显著增加（74次/分钟对88次/分钟，P<.05）。平均动脉压在孕晚期前保持稳定，与孕早期相比，孕晚期显著升高（78mmHg对86mmHg，P<.05）。SV和CO在孕早期和孕中期相对稳定，孕晚期显著下降。相反，SVR在孕晚期显著增加（P<.001）。虽然HRV和BPV在不同孕周没有变化，但与孕早期相比，孕晚期BRS显著降低（P<.05）。
孕期心血管和自主神经参数的无创测定是可行的，本初步研究结果可作为分类和评估孕期病理状况（如高血压疾病）中心血管和自主神经变化的基础参数。
