Lung function and postural changes during pregnancy.
ABSTRACT 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.
SourceAvailable from: Anita Teli[Show abstract] [Hide abstract]
ABSTRACT: Objective: Pregnancy is characterized by profound changes in the function of virtually every regulatory system in the human body. The events in pregnancy elicit one of the best examples of selective anatomical, physiological & biochemical adaptation that occurs during pregnancy & profound changes in respiratory physiology is a part of the same process. Thus this study was designed to evaluate the pulmonary function tests in 1 st , 2 nd and 3 rd trimesters of pregnancy & compare them with non-pregnant control group. Method: A cross-sectional study was carried in 200 healthy women in the age range of 19-35 years .The subjects were distributed in four groups, i.e control (non-pregnant) group and 1 st , 2 nd &3 rd trimester pregnant groups. Number of subjects in each group is 50. We recorded respiratory parameters in control and study groups. Statistical analysis done by 'Z' test. Result: There was significant decrease in FVC, PEFR & MEP in all trimesters of pregnancy with maximum decrease of FVC in 1 st trimester & PEFR, MEP in 2 nd trimester. Conclusion: The changes in pulmonary function are attributed to major adaptations in the maternal respiratory system & are also be influenced by the mechanical pressure of enlarging gravid uterus, elevating the diaphragm & restricting the movements of lungs thus hampering the forceful expiration & decrease in 1 st trimester might be due to decline in alveolar Pco 2 caused by hyperventilation which acts as bronchoconstrictor & due to sensitization of respiratory centre due to progesterone.08/2012; 648(8):3-8. DOI:10.7439/ijbar.v3i8.609
[Show abstract] [Hide abstract]
ABSTRACT: Patients awaiting transplantation should be counseled regarding posttransplant contraception and the potential adverse outcomes associated with posttransplant conception. Pregnancy should be avoided for at least 1-2 years post transplant to minimize the risks to allograft function and fetal well-being. Transplant patients, particularly lung transplant recipients, have an increased risk of maternal and neonatal pregnancy-related complications, including prematurity and low birth weight, postpartum graft loss, and long-term morbidity and mortality compared to other solid-organ recipients. Therefore, careful monitoring by a specialized transplant team is crucial. Maintenance of immunosuppression is recommended, except for mycophenolate and mammalian target of rapamycin inhibitors (mTORi), which should be replaced before conception. Immunosuppressants must be regularly monitored and dosing adjusted to avoid graft rejection. Monitoring during labor is mandatory and epidural anesthesia recommended. Vaginal delivery should be standard and cesarean delivery only performed for obstetric reasons. Breastfeeding poses risks of neonatal exposure to immunosuppressants and is generally contraindicated.Bailliè re s Best Practice and Research in Clinical Obstetrics and Gynaecology 08/2014; 28(8). DOI:10.1016/j.bpobgyn.2014.07.019 · 3.00 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Advances in lung transplantation have enabled women to successfully undertake pregnancies. This study explored outcomes in this group, including changes in lung function, kidney function, and calcineurin inhibitor (CNI) levels. A retrospective review identified 19 transplant recipients who had ever become pregnant at our center, and manual reviews of their medical records were completed for 14. Results of spirometry, serum creatinine, CNI doses and trough levels, and comorbidities were collected. Eight births occurred (42% success rate). Six patients have since died, with pregnancy contributing to 1 death. Five pregnancies were unplanned, with only 1 resulting in birth. Six pregnancies ended with spontaneous termination, and 2 were terminated for medical reasons. Mean age was 31.4 years (range, 22-39 years), and mean time from transplant was 76.2 months (range, 26-139 months). Complications included preeclampsia in 2, diabetes of pregnancy in 1, and abnormal liver enzymes in 1. Within 6 months of delivery, there were 2 cases of pneumonia, 2 cases of obliterative bronchiolitis, 1 case of tuberculosis, and 1 case of mild acute rejection. Forced expiratory volume in 1 second was stable at 3 (-1.5%; p = 0.55) and 12 months (1.4%; p = 0.84) after pregnancy. Mean change in Forced expiratory volume in 1 second during full-term pregnancies was -2.4% (p = 0.29), and the mean change in forced vital capacity was -0.8% (p = 0.55). In the first trimester, 83% of patients had a fall in creatinine, and a universal fall in CNI trough levels was seen. In carefully selected patients, planned pregnancy after lung transplant can be successful. Complications are common, and close monitoring of immunosuppression and renal function is needed.The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 02/2014; 33(6). DOI:10.1016/j.healun.2014.02.008 · 5.61 Impact Factor