Academic Obstetric Unit, Teaching Hospital, Galle, Sri Lanka.
Department of obstetrics and gynaecology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
PLoS One. 2023 Oct 18;18(10):e0284230. doi: 10.1371/journal.pone.0284230. eCollection 2023.
Pregnancy leads to a state of chronically increased intra-abdominal pressure (IAP) caused by a growing fetus, fluid, and tissue. Increased intra-abdominal pressure is leading to state of Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome. Clinical features and risk factors of preeclampsia is comparable to abdominal compartment syndrome. IAP may be associated with the hypertension in pregnancy (HIP).
The study aimed to determine the antepartum and postpartum IAP levels in women undergoing caesarean delivery (CD) and association between hypertension in pregnancy, and antepartum and postpartum IAP levels in women undergoing CD.
Seventy pregnant women (55 normotensive, 15 HIP) undergoing antepartum, non-emergency CD, had their intravesical pressure measured before and after the CD, the intravesical pressure measurements obtained with the patient in the supine position were considered to correspond to the IAP. Multivariable linear regression models were used to study associations between intraabdominal pressure and baseline characteristics in normotensive pregnancies and hypertensive pregnancies.
In normotensive pregnancies at mean gestation age of 38.2 weeks (95%CI 37.9 to 38.6), mean antepartum IAP was 12.7 mmHg(95%CI 11.6 to 13.8) and the mean postpartum IAP was 7.3 mmHg (95% CI 11.6 to 13.8). Multivariable linear regression models showed HIP group antepartum IAP positively associated with coefficient value of 1.617 (p = 0.268) comparing with normotensive pregnancy group. Postpartum IAP in HIP group positively associated with coefficient value of 2.519 (p = 0.018) comparing with normotensive pregnancy group. IAP difference is negatively associated with HIP (coefficient -1.013, p = 0.179).
In normotensive pregnancies at term, the IAP was in the IAH range of the non-pregnant population. Higher Antepartum IAP and Postpartum IAP are associated with HIP. Reduction of IAP from antepartum period to postpartum period was less with HIP.
怀孕会导致胎儿、液体和组织不断生长，使腹腔内压力（IAP）长期升高。不断升高的腹腔内压力会导致腹腔内高压（IAH）和腹腔间隔室综合征。先兆子痫的临床特征和危险因素与腹腔间隔室综合征相似。IAP 可能与妊娠高血压（HIP）有关。
本研究旨在确定行剖宫产术（CD）的孕妇产前和产后的 IAP 水平，并探讨妊娠高血压与行 CD 的孕妇产前和产后 IAP 水平之间的关系。
70 名孕妇（55 名血压正常，15 名 HIP）在产前非紧急情况下接受 CD，在 CD 前后测量其膀胱内压，患者取仰卧位时获得的膀胱内压测量值被认为与 IAP 相对应。多变量线性回归模型用于研究血压正常妊娠和高血压妊娠患者的 IAP 与基线特征之间的关系。
在血压正常的孕妇中，平均孕龄为 38.2 周（95%CI 37.9 至 38.6），平均产前 IAP 为 12.7mmHg（95%CI 11.6 至 13.8），平均产后 IAP 为 7.3mmHg（95%CI 11.6 至 13.8）。多变量线性回归模型显示，与血压正常妊娠组相比，HIP 组的产前 IAP 呈正相关，其系数值为 1.617（p=0.268）。与血压正常妊娠组相比，HIP 组的产后 IAP 呈正相关，其系数值为 2.519（p=0.018）。IAP 差值与 HIP 呈负相关（系数-1.013，p=0.179）。
在足月血压正常的孕妇中，IAP 处于非妊娠人群的 IAH 范围内。较高的产前 IAP 和产后 IAP 与 HIP 相关。与血压正常的妊娠组相比，HIP 组从产前到产后的 IAP 降低幅度较小。
