Respiratory Physiology in Pregnancy

Clinics in Chest Medicine

Volumn 32, Issue 1, 2011, Pages 1-13

  Hegewald, Matthew J ^a,b   Crapo, Robert O ^c  

^a UNIVERSITY OF UTAH SCHOOL OF MEDICINE   (United States)

^b INTERMOUNTAIN MEDICAL CENTER   (United States)

^c LDS HOSPITAL   (United States)

Author keywords

Pregnancy; Pulmonary function testing; Respiratory physiology

Indexed keywords

AEROBIC EXERCISE; AIRWAY CONDUCTANCE; AIRWAY RESISTANCE; BLOOD VOLUME; BREATHING MUSCLE; DELIVERY; EXERCISE INTENSITY; HEART HEMODYNAMICS; HEART MUSCLE BLOOD FLOW; HEART OUTPUT; HUMAN; LABOR; LUNG CIRCULATION; LUNG CLOSING VOLUME; LUNG DIFFUSION CAPACITY; LUNG GAS EXCHANGE; LUNG HEMODYNAMICS; LUNG VENTILATION; PREGNANCY; PRIORITY JOURNAL; PUERPERIUM; RESPIRATORY FUNCTION; REVIEW; SPIROMETRY; THORAX WALL; UPPER RESPIRATORY TRACT;

CARDIOVASCULAR PHYSIOLOGICAL PROCESSES; DYSPNEA; EXERCISE; FEMALE; HUMANS; PREGNANCY; PREGNANCY COMPLICATIONS; PREGNANCY COMPLICATIONS, CARDIOVASCULAR; RESPIRATORY FUNCTION TESTS; RESPIRATORY PHYSIOLOGICAL PROCESSES;

EID: 79251469067     PISSN: 02725231     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ccm.2010.11.001     Document Type: Review

References (98)

1. Lapinsky S.E. Cardiopulmonary complications of pregnancy. Crit Care Med 2005, 33(7):1616-1622.
2. Ellegard E.K. Pregnancy rhinitis. Immunol Allergy Clin North Am 2006, 26(1):119-135. vii.
3. Toppozada H., Michaels L., Toppozada M., et al. The human respiratory nasal mucosa in pregnancy. An electron microscopic and histochemical study. J Laryngol Otol 1982, 96(7):613-626.
4. Bende M., Gredmark T. Nasal stuffiness during pregnancy. Laryngoscope 1999, 109(7 Pt 1):1108-1110.
5. Ellegard E. Lakartidningen 2000, 97(34):3619-3620. 3623 [in Swedish].
6. Mabry R.L. Rhinitis of pregnancy. South Med J 1986, 79(8):965-971.
7. Ellegard E.K. Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol 2004, 26(3):149-159.
8. Pien G.W., Schwab R.J. Sleep disorders during pregnancy. Sleep 2004, 27(7):1405-1417.
9. Lundberg J.O., Weitzberg E. Nasal nitric oxide in man. Thorax 1999, 54(10):947-952.
10. Pilkington S., Carli F., Dakin M.J., et al. Increase in Mallampati score during pregnancy. Br J Anaesth 1995, 74(6):638-642.
11. Izci B., Vennelle M., Liston W.A., et al. Sleep-disordered breathing and upper airway size in pregnancy and post-partum. Eur Respir J 2006, 27(2):321-327.
12. Pien G.W., Fife D., Pack A.I., et al. Changes in symptoms of sleep-disordered breathing during pregnancy. Sleep 2005, 28(10):1299-1305.
13. Izci B., Riha R.L., Martin S.E., et al. The upper airway in pregnancy and pre-eclampsia. Am J Respir Crit Care Med 2003, 167(2):137-140.
14. White D.P. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med 2005, 172(11):1363-1370.
15. Contreras G., Gutierrez M., Beroiza T., et al. Ventilatory drive and respiratory muscle function in pregnancy. Am Rev Respir Dis 1991, 144(4):837-841.
16. Elkus R., Popovich J. Respiratory physiology in pregnancy. Clin Chest Med 1992, 13(4):555-565.
17. Crapo R.O. Normal cardiopulmonary physiology during pregnancy. Clin Obstet Gynecol 1996, 39(1):3-16.
18. Weinberger S.E., Weiss S.T., Cohen W.R., et al. Pregnancy and the lung. Am Rev Respir Dis 1980, 121(3):559-581.
19. Goldsmith L.T., Weiss G., Steinetz B.G. Relaxin and its role in pregnancy. Endocrinol Metab Clin North Am 1995, 24(1):171-186.
20. Gilroy R.J., Mangura B.T., Lavietes M.H. Rib cage and abdominal volume displacements during breathing in pregnancy. Am Rev Respir Dis 1988, 137(3):668-672.
21. Marx G.F., Murthy P.K., Orkin L.R. Static compliance before and after vaginal delivery. Br J Anaesth 1970, 42(12):1100-1104.
22. Gee J.B., Packer B.S., Millen J.E., et al. Pulmonary mechanics during pregnancy. J Clin Invest 1967, 46(6):945-952.
23. Cugell D.W., Frank N.R., Gaensler E.A., et al. Pulmonary function in pregnancy. I. Serial observations in normal women. Am Rev Tuberc 1953, 67(5):568-597.
24. Garrard G.S., Littler W.A., Redman C.W. Closing volume during normal pregnancy. Thorax 1978, 33(4):488-492.
25. Alaily A.B., Carrol K.B. Pulmonary ventilation in pregnancy. Br J Obstet Gynaecol 1978, 85(7):518-524.
26. Norregaard O., Schultz P., Ostergaard A., et al. Lung function and postural changes during pregnancy. Respir Med 1989, 83(6):467-470.
27. Garcia-Rio F., Pino-Garcia J.M., Serrano S., et al. Comparison of helium dilution and plethysmographic lung volumes in pregnant women. Eur Respir J 1997, 10(10):2371-2375.
28. Prowse C.M., Gaensler E.A. Respiratory and acid-base changes during pregnancy. Anesthesiology 1965, 26:381-392.
29. Wanger J., Clausen J.L., Coates A., et al. Standardisation of the measurement of lung volumes. Eur Respir J 2005, 26(3):511-522.
30. Ferris B.G. Epidemiology standardization project (American Thoracic Society). Am Rev Respir Dis 1978, 118(6 Pt 2):1-120.
31. Unterborn J. Pulmonary function testing in obesity, pregnancy, and extremes of body habitus. Clin Chest Med 2001, 22(4):759-767.
32. Goucher D., Rubin A., Russo N. The effect of pregnancy upon pulmonary function in normal women. Am J Obstet Gynecol 1956, 72(5):963-969.
33. Ihrman K. A clinical and physiological study of pregnancy in a material from northern Sweden. II. Vital capacity and maximal breathing capacity during and after pregnancy. Acta Soc Med Ups 1960, 65:147-154.
34. Milne J.A., Mills R.J., Howie A.D., et al. Large airways function during normal pregnancy. Br J Obstet Gynaecol 1977, 84(6):448-451.
35. Baldwin G.R., Moorthi D.S., Whelton J.A., et al. New lung functions and pregnancy. Am J Obstet Gynecol 1977, 127(3):235-239.
36. Puranik B.M., Kaore S.B., Kurhade G.A., et al. A longitudinal study of pulmonary function tests during pregnancy. Indian J Physiol Pharmacol 1994, 38(2):129-132.
37. Gazioglu K., Kaltreider N.L., Rosen M., et al. Pulmonary function during pregnancy in normal women and in patients with cardiopulmonary disease. Thorax 1970, 25(4):445-450.
38. McAuliffe F., Kametas N., Costello J., et al. Respiratory function in singleton and twin pregnancy. BJOG 2002, 109(7):765-769.
39. Kerr J.H. Bronchopulmonary resistance in pregnancy. Can Anaesth Soc J 1961, 8:347-355.
40. Levitzky M.G. Pulmonary physiology 2007, McGraw-Hill, New York (NY). 7th edition.
41. Milic-Emili J., Torchio R., D'Angelo E. Closing volume: a reappraisal (1967-2007). Eur J Appl Physiol 2007, 99(6):567-583.
42. Bevan D.R., Holdcroft A., Loh L., et al. Closing volume and pregnancy. Br Med J 1974, 1(5896):13-15.
43. Craig D.B., Toole M.A. Airway closure in pregnancy. Can Anaesth Soc J 1975, 22(6):665-672.
44. Awe R.J., Nicotra M.B., Newsom T.D., et al. Arterial oxygenation and alveolar-arterial gradients in term pregnancy. Obstet Gynecol 1979, 53(2):182-186.
45. Russell I.F., Chambers W.A. Closing volume in normal pregnancy. Br J Anaesth 1981, 53(10):1043-1047.
46. Fishburne J.I. Physiology and disease of the respiratory system in pregnancy. A review. J Reprod Med 1979, 22(4):177-189.
47. Burki N.K., Barker D.B., Nicholson D.P. Variability of the closing volume measurement in normal subjects. Am Rev Respir Dis 1975, 112(2):209-212.
48. Camann W.R., Ostheimer G.W. Physiological adaptations during pregnancy. Int Anesthesiol Clin 1990, 28(1):2-10.
49. Milne J.A., Mills R.J., Coutts J.R., et al. The effect of human pregnancy on the pulmonary transfer factor for carbon monoxide as measured by the single-breath method. Clin Sci Mol Med 1977, 53(3):271-276.
50. Krumholz R.A., Echt C.R., Ross J.C. Pulmonary diffusing capacity, capillary blood volume, lung volumes, and mechanics of ventilation in early and late pregnancy. J Lab Clin Med 1964, 63:648-655.
51. Bedell G.N., Adams R.W. Pulmonary diffusing capacity during rest and exercise. a study of normal persons and persons with atrial septal defect, pregnancy, and pulmonary disease. J Clin Invest 1962, 41(10):1908-1914.
52. Knuttgen H.G., Emerson K. Physiological response to pregnancy at rest and during exercise. J Appl Physiol 1974, 36(5):549-553.
53. Milne J.A. The respiratory response to pregnancy. Postgrad Med J 1979, 55(643):318-324.
54. Rees G.B., Broughton Pipkin F., Symonds E.M., et al. A longitudinal study of respiratory changes in normal human pregnancy with cross-sectional data on subjects with pregnancy-induced hypertension. Am J Obstet Gynecol 1990, 162(3):826-830.
55. Garcia-Rio F., Pino J.M., Gomez L., et al. Regulation of breathing and perception of dyspnea in healthy pregnant women. Chest 1996, 110(2):446-453.
56. Pernoll M.L., Metcalfe J., Kovach P.A., et al. Ventilation during rest and exercise in pregnancy and postpartum. Respir Physiol 1975, 25(3):295-310.
57. 2), physiological shunt and VD/VT in normal pregnancy. Br J Anaesth 1976, 48(10):1001-1004.
58. Shankar K.B., Moseley H., Vemula V., et al. Physiological dead space during general anaesthesia for Caesarean section. Can J Anaesth 1987, 34(4):373-376.
59. Bayliss D.A., Millhorn D.E. Central neural mechanisms of progesterone action: application to the respiratory system. J Appl Physiol 1992, 73(2):393-404.
60. Zwillich C.W., Natalino M.R., Sutton F.D., et al. Effects of progesterone on chemosensitivity in normal men. J Lab Clin Med 1978, 92(2):262-269.
61. Schoene R.B., Pierson D.J., Lakshminarayan S., et al. Effect of medroxyprogesterone acetate on respiratory drives and occlusion pressure. Bull Eur Physiopathol Respir 1980, 16(5):645-653.
62. Jensen D., Wolfe L.A., Slatkovska L., et al. Effects of human pregnancy on the ventilatory chemoreflex response to carbon dioxide. Am J Physiol Regul Integr Comp Physiol 2005, 288(5):R1369-R1375.
63. Liberatore S.M., Pistelli R., Patalano F., et al. Respiratory function during pregnancy. Respiration 1984, 46(2):145-150.
64. Hannhart B., Pickett C.K., Moore L.G. Effects of estrogen and progesterone on carotid body neural output responsiveness to hypoxia. J Appl Physiol 1990, 68(5):1909-1916.
65. Gilbert R., Auchincloss J.H. Dyspnea of pregnancy. Clinical and physiological observations. Am J Med Sci 1966, 252(3):270-276.
66. Tenholder M.F., South-Paul J.E. Dyspnea in pregnancy. Chest 1989, 96(2):381-388.
67. Ueland K., Novy M.J., Metcalfe J. Cardiorespiratory responses to pregnancy and exercise in normal women and patients with heart disease. Am J Obstet Gynecol 1973, 115(1):4-10.
68. Pernoll M.L., Metcalfe J., Schlenker T.L., et al. Oxygen consumption at rest and during exercise in pregnancy. Respir Physiol 1975, 25(3):285-293.
69. Artal R., Wiswell R., Romem Y., et al. Pulmonary responses to exercise in pregnancy. Am J Obstet Gynecol 1986, 154(2):378-383.
70. Lucius H., Gahlenbeck H., Kleine H.O., et al. Respiratory functions, buffer system, and electrolyte concentrations of blood during human pregnancy. Respir Physiol 1970, 9(3):311-317.
71. Dayal P., Murata Y., Takamura H. Antepartum and postpartum acid-base changes in maternal blood in normal and complicated pregnancies. J Obstet Gynaecol Br Commonw 1972, 79:612-624.
72. Archer G.W., Marx G.F. Arterial oxygen tension during apnoea in parturient women. Br J Anaesth 1974, 46(5):358-360.
73. Ang C.K., Tan T.H., Walters W.A., et al. Postural influence on maternal capillary oxygen and carbon dioxide tension. Br Med J 1969, 4(5677):201-203.
74. Tsai C.H., de Leeuw N.K. Changes in 2,3-diphosphoglycerate during pregnancy and puerperium in normal women and in beta-thalassemia heterozygous women. Am J Obstet Gynecol 1982, 142(5):520-523.
75. Brown M.A., Gallery E.D. Volume homeostasis in normal pregnancy and pre-eclampsia: physiology and clinical implications. Baillieres Clin Obstet Gynaecol 1994, 8(2):287-310.
76. Hytten F. Blood volume changes in normal pregnancy. Clin Haematol 1985, 14(3):601-612.
77. Cadnapaphornchai M.A., Ohara M., Morris K.G., et al. Chronic NOS inhibition reverses systemic vasodilation and glomerular hyperfiltration in pregnancy. Am J Physiol Renal Physiol 2001, 280(4):F592-F598.
78. Longo L.D. Maternal blood volume and cardiac output during pregnancy: a hypothesis of endocrinologic control. Am J Physiol 1983, 245(5 Pt 1):R720-R729.
79. Wilson M., Morganti A.A., Zervoudakis I., et al. Blood pressure, the renin-aldosterone system and sex steroids throughout normal pregnancy. Am J Med 1980, 68(1):97-104.
80. Sala C., Campise M., Ambroso G., et al. Atrial natriuretic peptide and hemodynamic changes during normal human pregnancy. Hypertension 1995, 25(4 Pt 1):631-636.
81. Bader R.A., Bader M.E., Rose D.F., et al. Hemodynamics at rest and during exercise in normal pregnancy as studies by cardiac catheterization. J Clin Invest 1955, 34(10):1524-1536.
82. Clark S.L., Cotton D.B., Lee W., et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 1989, 161(6 Pt 1):1439-1442.
83. Robson S.C., Hunter S., Boys R.J., et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989, 256(4 Pt 2):H1060-H1065.
84. Mabie W.C., DiSessa T.G., Crocker L.G., et al. A longitudinal study of cardiac output in normal human pregnancy. Am J Obstet Gynecol 1994, 170(3):849-856.
85. van Oppen A.C., Stigter R.H., Bruinse H.W. Cardiac output in normal pregnancy: a critical review. Obstet Gynecol 1996, 87(2):310-318.
86. Hunter S., Robson S.C. Adaptation of the maternal heart in pregnancy. Br Heart J 1992, 68(6):540-543.
87. Ueland K., Metcalfe J. Circulatory changes in pregnancy. Clin Obstet Gynecol 1975, 18(3):41-50.
88. Kramer M.S., McDonald S.W. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev 2006, 3. CD000180.
89. Wolfe L.A., Weissgerber T.L. Clinical physiology of exercise in pregnancy: a literature review. J Obstet Gynaecol Can 2003, 25(6):473-483.
90. Bung P., Bung C., Artal R., et al. Therapeutic exercise for insulin-requiring gestational diabetics: effects on the fetus-results of a randomized prospective longitudinal study. J Perinat Med 1993, 21(2):125-137.
91. Dempsey J.C., Sorensen T.K., Williams M.A., et al. Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 2004, 159(7):663-670.
92. Gorski J. Exercise during pregnancy: maternal and fetal responses. A brief review. Med Sci Sports Exerc 1985, 17(4):407-416.
93. Wolfe L.A., Walker R.M., Bonen A., et al. Effects of pregnancy and chronic exercise on respiratory responses to graded exercise. J Appl Physiol 1994, 76(5):1928-1936.
94. Cole P.V., Nainby-Luxmoore R.C. Respiratory volumes in labour. Br Med J 1962, 1(5285):1118.
95. Reid D.H. Respiratory changes in labour. Lancet 1966, 1(7441):784-785.
96. Fujitani S., Baldisseri M.R. Hemodynamic assessment in a pregnant and peripartum patient. Crit Care Med 2005, 33(Suppl 10):S354-S361.
97. Robson S.C., Hunter S., Moore M., et al. Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol 1987, 94(11):1028-1039.
98. Capeless E.L., Clapp J.F. When do cardiovascular parameters return to their preconception values?. Am J Obstet Gynecol 1991, 165(4 Pt 1):883-886.