Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, United States.
Handb Clin Neurol. 2020;171:85-96. doi: 10.1016/B978-0-444-64239-4.00004-7.
The adaptation of the cerebral circulation to pregnancy is unique compared with other organs and circulatory systems, because the brain requires relatively constant blood flow and water and solute composition to maintain homeostasis. Thus, a major adaptation of the maternal cerebrovasculature to pregnancy is to maintain normalcy in the face of expanded plasma volume, increased cardiac output, and high levels of permeability factors. In this chapter, the effect of pregnancy on critical functions of the cerebral circulation is discussed, including changes occurring at the endothelium and blood-brain barrier (BBB), which protect the maternal brain from changes in BBB permeability. Further, pregnancy-induced changes in the structure and function of cerebral arteries, arterioles, and veins will be discussed as they relate to cerebral vascular resistance, hemodynamics, and cerebral blood flow autoregulation.
与其他器官和循环系统相比，大脑循环对妊娠的适应是独特的，因为大脑需要相对恒定的血流量以及水和溶质组成来维持内环境稳定。因此，孕产妇脑血管系统的主要适应机制是在面对扩大的血浆容量、增加的心输出量和高水平的通透性因子的情况下维持正常。在这一章中，讨论了妊娠对大脑循环的关键功能的影响，包括内皮细胞和血脑屏障（BBB）发生的变化，这些变化可保护母体大脑免受 BBB 通透性改变的影响。此外，还将讨论妊娠引起的脑动脉、小动脉和静脉的结构和功能变化，因为它们与脑血管阻力、血液动力学和脑血流自动调节有关。
