与怀孕相关的速度-压力产品的变化
Claudio V Schenone1, M Ashley Cain1, Aldo L Schenone2
1Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL (Drs C Schenone, Cain, Louis, and Crousillat).
American journal of obstetrics & gynecology MFM
|March 7, 2024
概括
怀孕显著增加了心肌的氧气需求,用速率-压力产物 (心率 × 缩血压) 来衡量,在第三个三个月和分娩期间达到峰值. 较低的孕前体重指数与这种心血管标志物的较大增加有关.
科学领域:
- 心血管生理学心血管生理学
- 生殖医学 生殖医学
- 产科 产科 产科 产科 产科
背景情况:
- 速率-压力乘积 (RPP),计算为心率乘以缩血压,作为心肌氧消耗在非怀孕个体的非侵入性指标.
- 怀孕是对心血管系统的生理压力,但它对心肌氧需求的确切影响,通过RPP评估,仍然不完全理解.
- 目前关于怀孕如何影响心肌氧需求的现有证据有限,使用RPP作为代孕,是有限的.
研究的目的:
- 在低风险怀孕中,在整个怀孕三季度,分娩和分娩以及产后期间,对速压产品的时间变化进行表征.
- 量化这些变化相对于预先概念水平的规模.
- 探索孕前体重指数,年龄和神经轴麻醉对怀孕和分娩期间RPP变化的影响.
主要方法:
- 一个回顾性队列研究,涉及316个没有并发症的怀孕,通过阴道分娩到期.
- 速度-压力产物 (RPP) 值在怀孕前,怀孕每个三个月,分娩和分娩的多个阶段以及分娩后访问期间收集.
- 统计分析,包括混合线性建模,用于评估随时间变化的RPP和人口统计和麻醉因素的影响.
主要成果:
- 从怀孕前的水平观察到平均RPP的显著增加,从第三个三个月开始,持续到分娩和分娩.
- 与怀孕前值相比,平均RPP的峰值在第三个季度增加了12%,在分娩和分娩期间增加了38%.
- 较低的孕前体重指数与RPP的较大增加有显著的相关性 (估计=-0.308,P=.008),而孕前年龄和神经轴麻醉状态并没有显著影响RPP变化.
结论:
- 这项研究证实,在无并发期怀孕期间,速率-压力产品的暂时但显著升高,反映了心肌氧氧气需求的增加.
- 怀孕前体重指数较低的孕妇在RPP中表现出更明显的增加.
- 在分娩和分娩期间的神经轴麻醉似乎不会显著改变RPP变化的模式,而不是那些没有.
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