Changes in maternal heart dimensions and plasma atrial natriuretic peptide levels in the early puerperium of normal and pre-eclamptic pregnancies

A. M. Pouta, Juha Rasanen, K. E J Airaksinen, O. J. Vuolteenaho, T. J. Laatikainen

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To measure plasma atrial natriuretic peptide (ANP) in relation to maternal haemodynamics and body fluid balance in the early puerperium following uncomplicated pregnancy and pre-eclampsia. Design: A longitudinal study from late pregnancy and into the early postpartum period (days 1 to 3 and days 4 to 6) compared with nonpregnant controls. Subjects: Eleven women with uncomplicated pregnancies, 12 women with pre-eclampsia and 12 healthy, nonpregnant women. Main outcome measures: Maternal heart dimensions determined by M-mode echocardiography, concentrations of ANP, and daily urine output and sodium excretion. Results: After delivery increases in left atrial dimensions, represented as mean (SEM), from 33.2 (1.6) to 37.7 (1.7) mm and ANP levels from 7.9 (1.1) to 19.0 (2.7) pmol/L were observed at 1-3 days postpartum in normal pregnant women, but we were not able to demonstrate a significant increase in diuresis and natriuresis. In the third trimester left atrial dimensions (38.4 (1.2) mm) and ANP levels (15.4 (2.2) pmol/L) were greater in pre-eclampsia. ANP levels rose further in pre-eclamptic women in the early puerperium (27.4 (7.4) pmol/L) with an increase in diuresis and natriuresis, while left atrial dimensions did not change significantly (39.4 (1.7) mm). A pericardial effusion was found in 11 pre-eclamptic but in only three healthy pregnant women. Conclusions: A concommitant increase in left atrial dimensions and ANP in the early puerperium following uncomplicated pregnancies is consistent with the mechanism of atrial stretch as a stimulus for ANP release, although the biological significance of this finding remained unclear. A significantly higher release of ANP in the early puerperium after pregnancies complicated by pre-eclampsia may be a mechanism which promotes the renal elimination of excessive body fluids and sodium.

Original languageEnglish (US)
Pages (from-to)988-992
Number of pages5
JournalBritish Journal of Obstetrics and Gynaecology
Volume103
Issue number10
StatePublished - 1996
Externally publishedYes

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Atrial Natriuretic Factor
Postpartum Period
Mothers
Pregnancy
Pre-Eclampsia
Natriuresis
Diuresis
Body Fluids
Pregnant Women
Sodium
Water-Electrolyte Balance
Pericardial Effusion
Third Pregnancy Trimester
Longitudinal Studies
Echocardiography
Hemodynamics
Outcome Assessment (Health Care)
Urine

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Changes in maternal heart dimensions and plasma atrial natriuretic peptide levels in the early puerperium of normal and pre-eclamptic pregnancies. / Pouta, A. M.; Rasanen, Juha; Airaksinen, K. E J; Vuolteenaho, O. J.; Laatikainen, T. J.

In: British Journal of Obstetrics and Gynaecology, Vol. 103, No. 10, 1996, p. 988-992.

Research output: Contribution to journalArticle

Pouta, A. M. ; Rasanen, Juha ; Airaksinen, K. E J ; Vuolteenaho, O. J. ; Laatikainen, T. J. / Changes in maternal heart dimensions and plasma atrial natriuretic peptide levels in the early puerperium of normal and pre-eclamptic pregnancies. In: British Journal of Obstetrics and Gynaecology. 1996 ; Vol. 103, No. 10. pp. 988-992.
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T1 - Changes in maternal heart dimensions and plasma atrial natriuretic peptide levels in the early puerperium of normal and pre-eclamptic pregnancies

AU - Pouta, A. M.

AU - Rasanen, Juha

AU - Airaksinen, K. E J

AU - Vuolteenaho, O. J.

AU - Laatikainen, T. J.

PY - 1996

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N2 - Objective: To measure plasma atrial natriuretic peptide (ANP) in relation to maternal haemodynamics and body fluid balance in the early puerperium following uncomplicated pregnancy and pre-eclampsia. Design: A longitudinal study from late pregnancy and into the early postpartum period (days 1 to 3 and days 4 to 6) compared with nonpregnant controls. Subjects: Eleven women with uncomplicated pregnancies, 12 women with pre-eclampsia and 12 healthy, nonpregnant women. Main outcome measures: Maternal heart dimensions determined by M-mode echocardiography, concentrations of ANP, and daily urine output and sodium excretion. Results: After delivery increases in left atrial dimensions, represented as mean (SEM), from 33.2 (1.6) to 37.7 (1.7) mm and ANP levels from 7.9 (1.1) to 19.0 (2.7) pmol/L were observed at 1-3 days postpartum in normal pregnant women, but we were not able to demonstrate a significant increase in diuresis and natriuresis. In the third trimester left atrial dimensions (38.4 (1.2) mm) and ANP levels (15.4 (2.2) pmol/L) were greater in pre-eclampsia. ANP levels rose further in pre-eclamptic women in the early puerperium (27.4 (7.4) pmol/L) with an increase in diuresis and natriuresis, while left atrial dimensions did not change significantly (39.4 (1.7) mm). A pericardial effusion was found in 11 pre-eclamptic but in only three healthy pregnant women. Conclusions: A concommitant increase in left atrial dimensions and ANP in the early puerperium following uncomplicated pregnancies is consistent with the mechanism of atrial stretch as a stimulus for ANP release, although the biological significance of this finding remained unclear. A significantly higher release of ANP in the early puerperium after pregnancies complicated by pre-eclampsia may be a mechanism which promotes the renal elimination of excessive body fluids and sodium.

AB - Objective: To measure plasma atrial natriuretic peptide (ANP) in relation to maternal haemodynamics and body fluid balance in the early puerperium following uncomplicated pregnancy and pre-eclampsia. Design: A longitudinal study from late pregnancy and into the early postpartum period (days 1 to 3 and days 4 to 6) compared with nonpregnant controls. Subjects: Eleven women with uncomplicated pregnancies, 12 women with pre-eclampsia and 12 healthy, nonpregnant women. Main outcome measures: Maternal heart dimensions determined by M-mode echocardiography, concentrations of ANP, and daily urine output and sodium excretion. Results: After delivery increases in left atrial dimensions, represented as mean (SEM), from 33.2 (1.6) to 37.7 (1.7) mm and ANP levels from 7.9 (1.1) to 19.0 (2.7) pmol/L were observed at 1-3 days postpartum in normal pregnant women, but we were not able to demonstrate a significant increase in diuresis and natriuresis. In the third trimester left atrial dimensions (38.4 (1.2) mm) and ANP levels (15.4 (2.2) pmol/L) were greater in pre-eclampsia. ANP levels rose further in pre-eclamptic women in the early puerperium (27.4 (7.4) pmol/L) with an increase in diuresis and natriuresis, while left atrial dimensions did not change significantly (39.4 (1.7) mm). A pericardial effusion was found in 11 pre-eclamptic but in only three healthy pregnant women. Conclusions: A concommitant increase in left atrial dimensions and ANP in the early puerperium following uncomplicated pregnancies is consistent with the mechanism of atrial stretch as a stimulus for ANP release, although the biological significance of this finding remained unclear. A significantly higher release of ANP in the early puerperium after pregnancies complicated by pre-eclampsia may be a mechanism which promotes the renal elimination of excessive body fluids and sodium.

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