Cardiovascular Complications Liu wei Department of ob gy Ren Ji hospital
Cardiovascular Complications Liu Wei Department of Ob & Gy Ren Ji hospital
General Consideration Cause of mother death The 2nd cause Incidence
General Consideration • Cause of mother death The 2nd cause • Incidence 1%-4%
General Consideration Antenatal cardiovascular changes 1. Blood volume increase by 40%0-60% Peaking at 32-34 weeks the expansion in plasma volume is greater than that expansion of red cell mass. 2. Cardiac output Increase by 4096-50 Peaking at 20-24 weeks
General Consideration • Antenatal cardiovascular changes 1. Blood volume increase by 40%-60% Peaking at 32 –34 weeks the expansion in plasma volume is greater than that expansion of red cell mass. 2. Cardiac output Increase by 40%-50% Peaking at 20-24 weeks
General Consideration 3. Blood pressure Decrease in the first trimester Rise to prepregnancy levels in the third trimester 4. Heart size Ventricular chamber size is increased Systolic function is unchanged
General Consideration 3. Blood pressure Decrease in the first trimester Rise to prepregnancy levels in the third trimester 4. Heart size Ventricular chamber size is increased Systolic function is unchanged
General Consideration Intrapartum cardiovaseular changes 1. First-stage labor 300ml -500ml t(each contraction) Cardiac output t(maternal pain, anxiety) 2. Second-stage labor Lung circulation f(bearing-down efforts to expel the fetus) Venous return,(after fetus is deliveried) Placental circulation is lost(after placenta is deliveried
General Consideration • Intrapartum cardiovascular changes 1. First-stage labor 300ml –500ml↑(each contraction) Cardiac output↑(maternal pain, anxiety) 2. Second-stage labor Lung circulation↑(bearing-down efforts to expel the fetus) Venous return↓(after fetus is deliveried) Placental circulation is lost (after placenta is deliveried)