Cardiovascular Complications
Cardiovascular Complications
General Consideration. Cause of mother deathThe2ndcause.Incidence1%-4%
General Consideration • Cause of mother death The 2nd cause • Incidence 1%-4%
General ConsiderationAntenatal cardiovascular changesBlood volumeincrease by40%-60%Peaking at 32-34 weeksthe expansion in plasma volume is greaterthan that expansion of red cell massCardiac outputIncreaseby40%-50%Peakingat20-24weeks
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 Consideration3.Blood pressureDecrease in the first trimesterRise to prepregnancy levels in the thirdtrimesterHeart sizeVentricular chamber size is increasedSystolic 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 ConsiderationIntrapartum cardiovascular changesFirst-stage labor300ml-500ml ↑ (each contraction)Cardiac output f (maternal pain, anxiety)2.Second-stage laborLung circulation ↑ (bearing-down efforts toexpelthefetus)Venous return (after fetus is deliveried)Placental circulation is lost (after placenta isdeliveried)
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)