Physiological changes in pregnancy
Physiological changes in pregnancy
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DOI：
10.1002/9780470994955.ch2
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Colman, Jack M.
中科院分区：
文献类型：
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作者：
Silversides, Candice K.;Colman, Jack M.
怀孕期间的生理变化促进了心血管系统适应母亲增加的代谢需求，从而能够向外周组织和胎儿提供充足的含氧血液。循环血容量（影响前负荷）、外周血管顺应性和阻力（影响后负荷）、心肌功能和收缩力、心率以及有时心律和神经激素系统发生变化（表2.1）。没有心脏病的女性适应性很好，不良心脏事件很少。在一些妇女中，心脏病可能首先在怀孕期间被发现，当时不充分的适应暴露了以前未被认识到的心脏储备限制。在存在重要的母体结构性心脏病的情况下，妊娠期心血管需求增加可导致心脏失代偿、心律失常，以及罕见的孕产妇死亡。这一章检查的生理变化怀孕，因为他们发生在产前期间，在劳动和交付（围产期）的时间，并在产后期间。
Physiological changes during pregnancy facilitate the adaptation of the cardiovascular system to the increased metabolic needs of the mother, thus enabling adequate delivery of oxygenated blood to peripheral tissues and the fetus. Changes occur in circulating blood volume (affecting preload), peripheral vascular compliance and resistance (affecting afterload), myocardial function and contractility, heart rate, and sometimes heart rhythm and the neurohormonal system (Table 2.1). Women without heart disease adapt well and adverse cardiac events are rare. In some women, heart disease may first be detected during pregnancy when inadequate adaptation exposes previously unrecognized limitations of cardiac reserve. In the presence of important maternal structural heart disease, increased cardiovascular demands of pregnancy can result in cardiac decompensation, arrhythmias, and, rarely, maternal death. This chapter examines the physiologic changes of pregnancy as they occur in the antepartum period, at the time of labour and delivery (peripartum), and in the postpartum period.