Obstet Gynecol Sci.  2016 Nov;59(6):427-433. 10.5468/ogs.2016.59.6.427.

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

Affiliations
  • 1Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea. md_cho@hanmail.net

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.

Keyword

Fetus; Gestational age; Postural change; Tei index

MeSH Terms

Cardiovascular System
Echocardiography
Female
Fetus
Gestational Age*
Gravitation
Homeostasis
Humans
Posture
Pregnancy
Supine Position

Figure

  • Fig. 1 The Tei index according to maternal postural changes in all fetuses.

  • Fig. 2 Isovolumic contraction time (A), ejection time (B), and isovolumic relaxation time (C) according to maternal postural changes, among all fetuses.

  • Fig. 3 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 to 40 weeks.

  • Fig. 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.


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