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Maternal cardiac function during pregnancy at high altitude
Nikos A Kametas1, Fionnuala McAuliffe, Elisabeth Krampl
1Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
BJOG : an International Journal of Obstetrics and Gynaecology
|September 24, 2004
Summary
Pregnancy at high altitude significantly reduces maternal cardiac output and intravascular space expansion compared to sea level. This adaptation is linked to lower birthweight and impaired left ventricular function.
Area of Science:
- Cardiovascular physiology
- Maternal-fetal medicine
- High-altitude adaptation
Background:
- Pregnancy necessitates significant maternal cardiovascular adaptations.
- High-altitude environments pose unique physiological challenges to pregnancy.
Purpose of the Study:
- To compare maternal cardiovascular adaptation in pregnancy at high altitude versus sea level.
- To investigate the impact of high altitude on cardiac output and left ventricular function during gestation.
Main Methods:
- Cross-sectional study comparing pregnant women at 4370 m (high altitude) and sea level.
- Echocardiography assessed maternal cardiac output and left ventricular systolic function.
- Population included pregnant women and non-pregnant controls at both locations.
Main Results:
- High-altitude pregnancy showed 31% lower maternal cardiac output due to reduced heart rate and stroke volume.
- Impaired longitudinal and transverse left ventricular systolic function observed at high altitude.
- Reduced intravascular space expansion and lower mean arterial pressure noted at high altitude.
Conclusions:
- High-altitude pregnancy is characterized by decreased cardiac output and stroke volume.
- Maternal intravascular space expansion is blunted at high altitude compared to sea level.
- These cardiovascular alterations may contribute to reduced fetal growth at high altitude.