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Abstract
Objective: To evaluate the effects of acute plasma volume expansion on central hemodynamic and plasma atrial natriuretic peptide concentration (ANP) during pregnancy as compared to the nonpregnant situation.
Methods: Fourteen healthy pregnant women were subjected to rapid infusion of 0.9% Ringer solution, 15 mL/kg body weight in the third trimester and 3 months postpartum. Blood was sampled for ANP measurement and hemodynamics were studied with echocardiography-Doppler technique before and immediately after the infusion.
Main Outcome Measures: Echocardiography- and Doppler-derived circulatory measures; ANP concentration.
Results: In the basal state, cardiac output was higher (6.2 vs. 4.7 L/min; P < 0.01) and systemic vascular resistance units lower (14.7 vs. 18.8; P < 0.01) during pregnancy. ANP concentrations did not differ significantly between the pregnant and the nonpregnant state (5.7 vs. 7.0 pmol/L). During volume expansion the cardiac output increase was enhanced in pregnancy (24% vs. 13%; P < 0.05), as was the decrease in systemic vascular resistance (17% vs. 9%; P < 0.05). The ANP response did not differ significantly between Ihe pregnant and nonpregnant situation (increase of 5.6 vs. 2.2 pmol/L; P > 0.10).
Conclusions: Normal pregnancy is associated with an enhanced systemic vasodilatation during acute volume expansion as compared to the nonpregnant state. The ANP response, however, seems to be essentially unaltered.