Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies
Purpose Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NIC...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2018-02, Vol.297 (2), p.353-363 |
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| creator | Lavie, Anat Ram, Maya Lev, Shaul Blecher, Yair Amikam, Uri Shulman, Yael Avnon, Tomer Weiner, Eran Many, Ariel |
| description | Purpose
Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term.
Methods
This prospective longitudinal study included women with twin (
n
= 27) or singleton pregnancies (
n
= 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24–36 and 48–72 h postpartum.
Results
By 24–36 h postpartum, the mean arterial pressure and the total peripheral resistance equaled preoperative values in both groups. The CO increased throughout the CS and peaked immediately after delivery in the singleton group (
P
|
| doi_str_mv | 10.1007/s00404-017-4601-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1970641644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2261528220</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-abc99735533d8458fc1cd2174474e6f29bfd6adf2fb150e0231b60351b0afe4f3</originalsourceid><addsrcrecordid>eNp1kc1q3TAQhUVpaG7TPkA2xdBNN05mJFmSlyH0DxKyaddClqUbBVt2JTshbx-Zm7YQyGqGmW-OxDmEnCKcIYA8zwAceA0oay4Aa_WG7JAzWoNEfEt20G49CHlM3ud8B4BUKfGOHNMWVatatiP22iwuRTNUt26c-sdoxmBzFWI1lEW1d3kxS5hiZWJfhXF0fdjm85SX2aRlHTc0h7gf3DLFXN3ns2p5KLM5uX000QaXP5Ajb4bsPj7XE_L729dflz_qq5vvPy8vrmrLJF1q09m2laxpGOsVb5S3aHuKknPJnfC07XwvTO-p77ABB5RhJ4A12IHxjnt2Qr4cdOc0_VnLz_UYsnXDYKKb1qyxlSA4Cs4L-vkFejetmw1ZUyqwoYpSKBQeKJumnJPzek5hNOlRI-gtAX1IQJcE9JaAVuXm07Py2hW3_l38tbwA9ADksop7l_4__brqEzmNkYM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261528220</pqid></control><display><type>article</type><title>Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies</title><source>SpringerLink Journals</source><creator>Lavie, Anat ; Ram, Maya ; Lev, Shaul ; Blecher, Yair ; Amikam, Uri ; Shulman, Yael ; Avnon, Tomer ; Weiner, Eran ; Many, Ariel</creator><creatorcontrib>Lavie, Anat ; Ram, Maya ; Lev, Shaul ; Blecher, Yair ; Amikam, Uri ; Shulman, Yael ; Avnon, Tomer ; Weiner, Eran ; Many, Ariel</creatorcontrib><description>Purpose
Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term.
Methods
This prospective longitudinal study included women with twin (
n
= 27) or singleton pregnancies (
n
= 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24–36 and 48–72 h postpartum.
Results
By 24–36 h postpartum, the mean arterial pressure and the total peripheral resistance equaled preoperative values in both groups. The CO increased throughout the CS and peaked immediately after delivery in the singleton group (
P
< 0.0001), after which it abruptly began to decline until reaching a nadir 24–36 h after delivery (
P
< 0.0001), while it remained steady throughout the CS and then dropped until 24–36 h after delivery in the twin group (
P
< 0.05). None of the studied parameters differed significantly between the groups for the 24–36 and 48–72 h postpartum measurements.
Conclusions
Hemodynamic parameters immediately before, during and shortly after CS in singleton and twin pregnancies are equivalent. Further evaluations of the value of NICaS™ in assessing cardiovascular-related pregnancy complications are warranted.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-017-4601-8</identifier><identifier>PMID: 29189893</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Endocrinology ; Gynecology ; Human Genetics ; Maternal-Fetal Medicine ; Medicine ; Medicine & Public Health ; Obstetrics/Perinatology/Midwifery ; Pregnancy</subject><ispartof>Archives of gynecology and obstetrics, 2018-02, Vol.297 (2), p.353-363</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2017</rights><rights>Archives of Gynecology and Obstetrics is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-abc99735533d8458fc1cd2174474e6f29bfd6adf2fb150e0231b60351b0afe4f3</citedby><cites>FETCH-LOGICAL-c372t-abc99735533d8458fc1cd2174474e6f29bfd6adf2fb150e0231b60351b0afe4f3</cites><orcidid>0000-0002-2684-0046</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-017-4601-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-017-4601-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29189893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lavie, Anat</creatorcontrib><creatorcontrib>Ram, Maya</creatorcontrib><creatorcontrib>Lev, Shaul</creatorcontrib><creatorcontrib>Blecher, Yair</creatorcontrib><creatorcontrib>Amikam, Uri</creatorcontrib><creatorcontrib>Shulman, Yael</creatorcontrib><creatorcontrib>Avnon, Tomer</creatorcontrib><creatorcontrib>Weiner, Eran</creatorcontrib><creatorcontrib>Many, Ariel</creatorcontrib><title>Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term.
Methods
This prospective longitudinal study included women with twin (
n
= 27) or singleton pregnancies (
n
= 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24–36 and 48–72 h postpartum.
Results
By 24–36 h postpartum, the mean arterial pressure and the total peripheral resistance equaled preoperative values in both groups. The CO increased throughout the CS and peaked immediately after delivery in the singleton group (
P
< 0.0001), after which it abruptly began to decline until reaching a nadir 24–36 h after delivery (
P
< 0.0001), while it remained steady throughout the CS and then dropped until 24–36 h after delivery in the twin group (
P
< 0.05). None of the studied parameters differed significantly between the groups for the 24–36 and 48–72 h postpartum measurements.
Conclusions
Hemodynamic parameters immediately before, during and shortly after CS in singleton and twin pregnancies are equivalent. Further evaluations of the value of NICaS™ in assessing cardiovascular-related pregnancy complications are warranted.</description><subject>Endocrinology</subject><subject>Gynecology</subject><subject>Human Genetics</subject><subject>Maternal-Fetal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Pregnancy</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kc1q3TAQhUVpaG7TPkA2xdBNN05mJFmSlyH0DxKyaddClqUbBVt2JTshbx-Zm7YQyGqGmW-OxDmEnCKcIYA8zwAceA0oay4Aa_WG7JAzWoNEfEt20G49CHlM3ud8B4BUKfGOHNMWVatatiP22iwuRTNUt26c-sdoxmBzFWI1lEW1d3kxS5hiZWJfhXF0fdjm85SX2aRlHTc0h7gf3DLFXN3ns2p5KLM5uX000QaXP5Ajb4bsPj7XE_L729dflz_qq5vvPy8vrmrLJF1q09m2laxpGOsVb5S3aHuKknPJnfC07XwvTO-p77ABB5RhJ4A12IHxjnt2Qr4cdOc0_VnLz_UYsnXDYKKb1qyxlSA4Cs4L-vkFejetmw1ZUyqwoYpSKBQeKJumnJPzek5hNOlRI-gtAX1IQJcE9JaAVuXm07Py2hW3_l38tbwA9ADksop7l_4__brqEzmNkYM</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Lavie, Anat</creator><creator>Ram, Maya</creator><creator>Lev, Shaul</creator><creator>Blecher, Yair</creator><creator>Amikam, Uri</creator><creator>Shulman, Yael</creator><creator>Avnon, Tomer</creator><creator>Weiner, Eran</creator><creator>Many, Ariel</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2684-0046</orcidid></search><sort><creationdate>20180201</creationdate><title>Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies</title><author>Lavie, Anat ; Ram, Maya ; Lev, Shaul ; Blecher, Yair ; Amikam, Uri ; Shulman, Yael ; Avnon, Tomer ; Weiner, Eran ; Many, Ariel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-abc99735533d8458fc1cd2174474e6f29bfd6adf2fb150e0231b60351b0afe4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Endocrinology</topic><topic>Gynecology</topic><topic>Human Genetics</topic><topic>Maternal-Fetal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Pregnancy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lavie, Anat</creatorcontrib><creatorcontrib>Ram, Maya</creatorcontrib><creatorcontrib>Lev, Shaul</creatorcontrib><creatorcontrib>Blecher, Yair</creatorcontrib><creatorcontrib>Amikam, Uri</creatorcontrib><creatorcontrib>Shulman, Yael</creatorcontrib><creatorcontrib>Avnon, Tomer</creatorcontrib><creatorcontrib>Weiner, Eran</creatorcontrib><creatorcontrib>Many, Ariel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lavie, Anat</au><au>Ram, Maya</au><au>Lev, Shaul</au><au>Blecher, Yair</au><au>Amikam, Uri</au><au>Shulman, Yael</au><au>Avnon, Tomer</au><au>Weiner, Eran</au><au>Many, Ariel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>297</volume><issue>2</issue><spage>353</spage><epage>363</epage><pages>353-363</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
Differences in hemodynamic changes during a cesarean section (CS) between twin and singleton pregnancies are poorly defined. The Non-Invasive Cardiac System (NICaS) is an impedance device that measures cardiac output (CO) and its derivatives. We compared maternal cardiac parameters using NICaS™ in singleton and twins before and during delivery, as well at the early puerperium in healthy women undergoing CS at term.
Methods
This prospective longitudinal study included women with twin (
n
= 27) or singleton pregnancies (
n
= 62) whose hemodynamic parameters were assessed by NICaS before an elective CS, after spinal anesthesia, immediately after delivery, after fascia closure, and within 24–36 and 48–72 h postpartum.
Results
By 24–36 h postpartum, the mean arterial pressure and the total peripheral resistance equaled preoperative values in both groups. The CO increased throughout the CS and peaked immediately after delivery in the singleton group (
P
< 0.0001), after which it abruptly began to decline until reaching a nadir 24–36 h after delivery (
P
< 0.0001), while it remained steady throughout the CS and then dropped until 24–36 h after delivery in the twin group (
P
< 0.05). None of the studied parameters differed significantly between the groups for the 24–36 and 48–72 h postpartum measurements.
Conclusions
Hemodynamic parameters immediately before, during and shortly after CS in singleton and twin pregnancies are equivalent. Further evaluations of the value of NICaS™ in assessing cardiovascular-related pregnancy complications are warranted.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29189893</pmid><doi>10.1007/s00404-017-4601-8</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2684-0046</orcidid></addata></record> |
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| language | eng |
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| source | SpringerLink Journals |
| subjects | Endocrinology Gynecology Human Genetics Maternal-Fetal Medicine Medicine Medicine & Public Health Obstetrics/Perinatology/Midwifery Pregnancy |
| title | Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies |
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