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Adaptive responses of cardiac function to fetal postural change as gestational age increases

View Article: PubMed Central - PubMed

ABSTRACT

Objective: The cardiovascular system maintains homeostasis through a series of adaptive responses to physiological requirements. However, little is known about the adaptation of fetal cardiac function to gravity, according to gestational age. In the present study, we aimed to evaluate the adaptive responses of cardiac function to postural changes, using Tei index measurements.

Methods: Fetal echocardiography and Doppler examination were performed on 114 women with vertex singleton pregnancies at 19 to 40 weeks' gestation. Participants were placed in an upright seated position, and the Tei index for fetal left ventricular cardiac function was measured. The women were then moved into a supine position and the Tei index was re-measured.

Results: The mean Tei index when measured in an upright seated position was significantly lower than that measured in a supine positioning for all fetuses (0.528±0.103 vs. 0.555±0.106, P=0.014, respectively). This difference was also noted in fetuses with a gestational age of 28–40 weeks (0.539±0.107 vs. 0.574±0.102, P=0.011, respectively). However, there was no difference in the Tei index between an upright seated and a supine position among fetuses with a gestational age of <28 weeks (0.505±0.091 vs. 0.516±0.103, P=0.571, respectively).

Conclusion: Postural changes from an upright seated to a supine position result in an increased Tei index after a gestational age of 28 weeks. This appears to reflect maturation in the adaptive responses of the fetal cardiovascular system to postural changes.

No MeSH data available.


Related in: MedlinePlus

The Tei index (A), isovolumic contraction time (B), ejection time (C), and isovolumic relaxation time (D) according to maternal postural changes, among fetuses with a gestational age of <28 weeks.
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Figure 4: The Tei index (A), isovolumic contraction time (B), ejection time (C), and isovolumic relaxation time (D) according to maternal postural changes, among fetuses with a gestational age of <28 weeks.

Mentions: Participants were divided into two subgroups for additional analysis. One group consisted of fetuses with a gestational age of 28 to 40 weeks (n=77), and the other group included fetuses with a gestational age of <28 weeks (n=37). The mean Tei index and IRT associated with the upright seated position were significantly lower than in the supine position, among fetuses with a gestation age of 28 to 40 weeks (Fig. 3). However, other parameters including ICT, and ET, were not different by postural change in this subgroup (Fig. 3). There was no difference in the Tei index, ICT, ET, IRT between the upright seated and supine positions, among fetuses with a gestational age of <28 weeks (Fig. 4).


Adaptive responses of cardiac function to fetal postural change as gestational age increases
The Tei index (A), isovolumic contraction time (B), ejection time (C), and isovolumic relaxation time (D) according to maternal postural changes, among fetuses with a gestational age of <28 weeks.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120061&req=5

Figure 4: The Tei index (A), isovolumic contraction time (B), ejection time (C), and isovolumic relaxation time (D) according to maternal postural changes, among fetuses with a gestational age of <28 weeks.
Mentions: Participants were divided into two subgroups for additional analysis. One group consisted of fetuses with a gestational age of 28 to 40 weeks (n=77), and the other group included fetuses with a gestational age of <28 weeks (n=37). The mean Tei index and IRT associated with the upright seated position were significantly lower than in the supine position, among fetuses with a gestation age of 28 to 40 weeks (Fig. 3). However, other parameters including ICT, and ET, were not different by postural change in this subgroup (Fig. 3). There was no difference in the Tei index, ICT, ET, IRT between the upright seated and supine positions, among fetuses with a gestational age of <28 weeks (Fig. 4).

View Article: PubMed Central - PubMed

ABSTRACT

Objective: The cardiovascular system maintains homeostasis through a series of adaptive responses to physiological requirements. However, little is known about the adaptation of fetal cardiac function to gravity, according to gestational age. In the present study, we aimed to evaluate the adaptive responses of cardiac function to postural changes, using Tei index measurements.

Methods: Fetal echocardiography and Doppler examination were performed on 114 women with vertex singleton pregnancies at 19 to 40 weeks' gestation. Participants were placed in an upright seated position, and the Tei index for fetal left ventricular cardiac function was measured. The women were then moved into a supine position and the Tei index was re-measured.

Results: The mean Tei index when measured in an upright seated position was significantly lower than that measured in a supine positioning for all fetuses (0.528&plusmn;0.103 vs. 0.555&plusmn;0.106, P=0.014, respectively). This difference was also noted in fetuses with a gestational age of 28&ndash;40 weeks (0.539&plusmn;0.107 vs. 0.574&plusmn;0.102, P=0.011, respectively). However, there was no difference in the Tei index between an upright seated and a supine position among fetuses with a gestational age of &lt;28 weeks (0.505&plusmn;0.091 vs. 0.516&plusmn;0.103, P=0.571, respectively).

Conclusion: Postural changes from an upright seated to a supine position result in an increased Tei index after a gestational age of 28 weeks. This appears to reflect maturation in the adaptive responses of the fetal cardiovascular system to postural changes.

No MeSH data available.


Related in: MedlinePlus