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[宫缩抑制剂治疗及仰卧位休克综合征时母体心血管参数的变化(作者译)]

[Changes in maternal cardiovascular parameter during tocolysis and in the dorsal position shock syndrome (author's transl)].

作者信息

Hiltmann W D, Weidinger H, Wiest W

出版信息

Z Geburtshilfe Perinatol. 1976 Oct;180(5):366-74.

PMID:969798
Abstract

Maternal circulatory parameters and fetal heart rate were measured in 25 healthy pregnant women in the last trimenon during treatment with Fenoterol, Fenoterol in combination with Verapamil and Verapamil alone. Dosages were used in accordance with the tocolytic guidelines from Weidinger and Wiest. We were able to demonstrate that the betamimetic Fenoterol alone and in combination with the Ca++-antagonist Verapamil strongly increases the maternal heart rate an the maternal cardiac output whereas the peripheral resistance decreases accordingly. The average blood pressure stayed leveled, so that a decreased uterine blood flow cannot be assumed under betamimetics from the maternal cardiovascular point of view. However, there are indications for an increased placental blood flow during tocolysis. The betamimetic drug show no significant effect on the fetal heart rate. Additional application of the Ca++-antagonist Verapamil during tocolysis with Fenoterol (in dosages usually used for tocolysis) doesn't change cardiovascular reactions caused by Fenoterol. Change in position from supine to left lateral position caused a short term increase in the maternal cardiac output even noted in pregnant women without a clinically observed cavasyndrom. These changes of maternal cardiac output are comparable with those in orthostatic stress situations.

摘要

在25名健康孕妇妊娠晚期使用非诺特罗、非诺特罗与维拉帕米联合用药以及单独使用维拉帕米治疗期间,对其母体循环参数和胎儿心率进行了测量。用药剂量按照魏丁格和维斯特的宫缩抑制指南使用。我们能够证明,单独使用拟交感神经药非诺特罗以及与钙离子拮抗剂维拉帕米联合使用时,会显著提高母体心率和心输出量,而外周阻力则相应降低。平均血压保持稳定,因此从母体心血管角度来看,在使用拟交感神经药时不能认为子宫血流量会减少。然而,有迹象表明在宫缩抑制期间胎盘血流量会增加。拟交感神经药对胎儿心率无显著影响。在使用非诺特罗进行宫缩抑制期间(使用通常用于宫缩抑制的剂量)额外应用钙离子拮抗剂维拉帕米,不会改变非诺特罗引起的心血管反应。从仰卧位改为左侧卧位会使母体心输出量短期增加,即使在没有临床观察到仰卧位综合征的孕妇中也是如此。这些母体心输出量的变化与直立性应激情况下的变化相当。

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