title: Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study.
abstract: Serial haemodynamic investigations were performed in 15 women at 38 weeks gestation and then 2, 6, 12 and 24 weeks after delivery. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic, pulmonary and mitral valves. Cardiac chamber size and ventricular function were investigated by M-mode echocardiography. Flow measurements at the three intracardiac sites correlated closely. Cardiac output fell from a mean of 7.42 l/min at 38 weeks to 4.96 l/min at 24 weeks after delivery, a fall of 33%. Most of this decrease (28%) had occurred by 2 weeks. This was associated with a 20% reduction in heart rate and an 18% reduction in stroke volume. By 2 weeks after delivery there was a significant decrease in left atrial dimension and left ventricular end-diastolic dimension. Left ventricular wall thickness and mass declined throughout the period of study as did aortic, pulmonary and mitral valve areas. M-mode derived indices of myocardial contractility were all significantly reduced by 2 weeks and thereafter showed no further change. No haemodynamic differences were found between lactating and non-lactating mothers.
authors.affiliation: University of Newcastle-upon-Tyne, Department of Obstetrics and Gynaecology, Princess Mary Maternity Hospital.
authors.forename: S C
authors.initials: SC
authors.lastname: Robson
authors.forename: S
authors.initials: S
authors.lastname: Hunter
authors.forename: M
authors.initials: M
authors.lastname: Moore
authors.forename: W
authors.initials: W
authors.lastname: Dunlop
mesh_terms: D000328:Adult; D002302:Cardiac Output; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D013318:Stroke Volume; D014463:Ultrasonography