The aim of this study was to determine the effects of postural changes on lung function in pregnant women during the first, second, third trimester and post partum. A significant decrease in FRC, PEF and FEV1 was observed as a result of the postural changes. Arterial oxygenation, MVV and DLCO remained largely the same.
"In each study, two to four diffusion tests were performed per session. DL CO decreased by 10–15% in the second and third trimester in both singleton and twin pregnancies compared to the first trimester and post-partum (Gazioglu et al., 1970; McAuliffe et al., 2002; Norregaard et al., 1989). Greater resistance to diffusion through the alveolar membrane (DM) and not a decrease in pulmonary capillary blood volume (Vc) accounted for the decrease in DL CO (Gazioglu et al., 1970). "
[Show abstract][Hide abstract] ABSTRACT: This paper reviews the scientific evidence for the safety of carbon monoxide (CO) and nitric oxide (NO) inhalation to measure pulmonary diffusing capacity (DL(CO) and DL(NO)) in pregnant women and their fetuses. In eight earlier studies, 650 pregnant women had DL(CO) measurements performed at various times during pregnancy, with a minimum of two to four tests per session. Both pregnant subjects that were healthy and those with medical complications were tested. No study reported adverse maternal, fetal, or neonatal outcomes from the CO inhalation in association with measuring DL(CO). Eleven pregnant women, chiefly with pulmonary hypertension, and 1105 pre-term neonates, mostly with respiratory failure, were administered various dosages of NO (5-80ppm for 4 weeks continuously in pregnant women, and 1-20ppm for 15min to 3 weeks for the neonates). NO treatment was found to be an effective therapy for pregnant women with pulmonary hypertension. In neonates with respiratory failure and pulmonary hypertension, NO therapy improved oxygenation and survival and has been associated with only minor, transient adverse effects. In conclusion, maternal carboxyhemoglobin ([Hb(CO)]) levels can safely increase to 5% per testing session when the dose-exposure limit is 0.3% CO inhalation for <or=3min, and for NO, 80ppm for <or=3min. The risk of late fetal or neonatal death from increased Hb(CO) from diffusion testing is considerably less than the risk of death from all causes reported by the Centers for Disease Control, and is therefore considered "minimal risk".
[Show abstract][Hide abstract] ABSTRACT: In conclusion, it is important to appreciate the anatomic and physiologic adaptations in pregnancy in order to accurately diagnose and treat cardiopulmonary disease states in the gravid woman. Without knowing what constitutes normalcy in pregnancy, inappropriate diagnosis and interventions may occur. Furthermore, this knowledge is fundamental for understanding how disease states affect pregnancy and how pregnancy affects disease.
Clinics in Chest Medicine 01/1993; 13(4):555-65. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We have measured arterial oxygen saturation (SpO2) continuously overnight in 13 non-pregnant (NP), 13 pregnant normotensive (NPIH) and 15 pregnant patients with a diagnosis of pregnancy-induced hypertension (PIH). The two pregnant groups did not differ in duration of pregnancy (> 35 weeks) and none was in labour. There was no significant difference in age between these three groups. Mean SpO2 in group NP was 98.5% (range 97-99%). This was significantly higher than that in group NPIH (95.2 (91-98) %) and group PIH (94.9 (89-99) %). In seven pregnant patients, more than 20% of the recording was spent with an SpO2 < 90%. We conclude that a significant number of pregnant women (> 35 weeks' gestation) suffer from prolonged nocturnal hypoxaemia.
BJA British Journal of Anaesthesia 12/1995; 75(6):678-82. DOI:10.1093/bja/75.6.678 · 4.85 Impact Factor
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