Bibliografías temáticas / Fetal haemodynamic

Literatura académica sobre el tema "Fetal haemodynamic"

Autor: Grafiati
Publicado: 11 de marzo de 2023

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Artículos de revistas sobre el tema "Fetal haemodynamic"

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Vermeulen, Marijn J., Romy Gaillard, Kozeta Miliku, Irwin Reiss, Eric A. P. Steegers, Vincent Jaddoe y Janine Felix. "Influence of genetic variants for birth weight on fetal growth and placental haemodynamics". Archives of Disease in Childhood - Fetal and Neonatal Edition 105, n.º 4 (30 de octubre de 2019): 393–98. http://dx.doi.org/10.1136/archdischild-2019-317044.

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ObjectiveTo determine the combined effect of 60 genetic variants (single nucleotide polymorphisms, SNPs), previously identified as being associated with birth weight, on fetal growth and placental haemodynamics throughout pregnancy.DesignProspective birth cohort (Generation R Study).SettingGeneral multiethnic population.Participants5374 singleton liveborn children with genome-wide association arrays and fetal growth data.MethodsLongitudinal and cross-sectional analyses of a genetic score of the total number of birth weight–increasing alleles across the 59 available SNPs and repeated fetal growth and haemodynamic measures.Main outcome measuresSD scores (SDS) of fetal weight, (femur) length, head circumference, umbilical artery pulsatility index, uterine artery mean resistance index and placental weight, in different periods of pregnancy until birth.ResultsIn longitudinal analyses, the effect of the genetic score on the fetal growth measures increased throughout pregnancy (p<0.001). At 20 weeks of gestation, the genetic score was not associated with any of the fetal growth measures, whereas at 30 weeks it was associated with all. The strongest effects were observed at birth: per SD increase in genetic score, birth weight increased by 0.15 SDS (95% confidence interval: 0.13 to 0.18), birth length by 0.12 SDS (0.08 to 0.19) and head circumference by 0.08 SDS (0.05 to 0.12). The genetic score was not associated with placental haemodynamics, but was associated with a 14 g (10 to 18) increase in placental weight per SDS increase in genetic score.ConclusionsOur results suggest that genetic variants related to birth weight exert their combined effect on fetal growth from second half of pregnancy onwards and have no effect on placental haemodynamics.
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Teixeira, Jeronima, Roberto Fogliani, Xenophon Giannakoulopoulos, Vivette Glover y NicholasM Fisk. "Fetal haemodynamic stress response to invasive procedures". Lancet 347, n.º 9001 (marzo de 1996): 624. http://dx.doi.org/10.1016/s0140-6736(96)91327-6.

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Luzi, G., G. Coata, E. Chiaradia, G. Caserta, M. M. Anceschi, E. V. Cosmi y G. C. Di Renzo. "MATERNAL HAEMODYNAMIC AND HAEMORRHELOGIC CONSIDERATIONS IN FETAL I.U.G.R." Journal of Perinatal Medicine 22, s1 (enero de 1994): 193–200. http://dx.doi.org/10.1515/jpme.1994.22.s1.193.

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Sivakumar, Kothandam y Del-Rossi Sean. "Pulmonary artery to left atrial fistula: haemodynamic changes traced from fetus to infancy until its interventional closure". Cardiology in the Young 28, n.º 10 (18 de julio de 2018): 1154–56. http://dx.doi.org/10.1017/s1047951118000616.

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AbstractCommunications between the pulmonary artery and left atrium cause cyanosis. The images document serial haemodynamic changes in such a fistula from fetal life to the postnatal period with a successful transcatheter intervention.
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Lakhno, Igor. "Fetal Non-invasive Electrocardiography Contributes to Better Diagnostics of Fetal Distress: A Cross-sectional Study Among Patients with Pre-eclampsia". Annals of the Academy of Medicine, Singapore 44, n.º 11 (15 de noviembre de 2015): 519–23. http://dx.doi.org/10.47102/annals-acadmedsg.v44n11p519.

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Introduction: Fetal distress is a result of acute or chronic disturbances in the system of “mother-placenta-fetus” in pre-eclampsia (PE). The aim of the investigation was to compare the accuracy of antenatal fetal distress diagnostics in cases of traditional cardiotocography (CTG) waveform evaluation and analysis of morphological non-invasive electrocardiogram (ECG) parameters in anterpartum patients with PE. Materials and Methods: Fetal non-invasive ECG antenatal recordings of 122 pregnant patients at 34 to 40 weeks of gestation were examined. In Group I, there were 32 women with physiological gestation and normal fetal condition according to haemodynamic Doppler values. Group II involved 48 patients with mild and moderate PE whom were performed Doppler investigation. In Group III, 42 patients with severe PE were monitored with haemodynamic Doppler. Results: Fetal autonomic tone was lower with the relative increase of low frequency (LF) branch in the patients of pre-eclamptic group. The increased value of the amplitude of mode (AMo) and stress index (SI) was associated with adrenergic overactivity. It has induced pQ and QT shortening, increased T/QRS ratio and decelerations appearance. The rate of antenatal fetal distress retrospectively was 31.1 % in PE. The traditional analysis of CTG parameters has showed sensitivity (72.7%) and specificity (87.1%). In addition to the conventional CTG analysis, evaluation of ECG parameters has contributed to better diagnostics of fetal distress. Sensitivity and specificity of non-invasive fetal ECG were absolutely equal in this study (100%). Conclusion: The results suggest that fetal non-invasive ECG monitoring is more objective than conventional CTG. Key words: Fetal heart rate variability, Fetal monitoring, Hypertensive disorders of pregnancy
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Salame-Waxman, Daniel, Mara Escudero-Salamanca y Nilda Espinola-Zavaleta. "Successful pregnancy in a patient with double outlet right ventricle". Cardiology in the Young 30, n.º 4 (30 de marzo de 2020): 594–96. http://dx.doi.org/10.1017/s1047951120000566.

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AbstractBackground:The double outlet right ventricle is uncommon and usually makes patients have haemodynamic and structural complications. Having a hyperdynamic state, such as pregnancy, with volume overload is very risky for a patient with complex CHD (CCHD). The diagnosis in early stages can prevent cardiac complications. The multi-disciplinary assessment of the disease lets patients make choices in treatment and reproductive life.Objective:Present a case of a successful pregnancy in a patient with a rare CCHD.Participant:A pregnant 19-year-old patient with a double outlet right ventricle without haemodynamic or structural complications and no fetal abnormalities.
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KISERUD, TORVID. "FETAL VENOUS CIRCULATION". Fetal and Maternal Medicine Review 14, n.º 1 (febrero de 2003): 57–95. http://dx.doi.org/10.1017/s0965539503001037.

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Ultrasound evaluation of the venous system is now a compulsory part of the haemodynamic assessment of the fetus. Once umbilical venous flow was introduced1,2 and its pulsatile pattern discovered in the compromised fetus,3 other sections of the venous system have been added or explored for possible diagnostic use: the inferior and superior vena cava,4,5 ductus venosus,6,7 hepatic veins,8 pulmonary veins,9,10 and intracranial veins.11-13 The following presentation is not intended to be a complete review of the fetal venous circulation, which is growing by the day, but rather to focus on some central issues with an emphasis on physiologic principles. The reason for this focus is that, as clinicians, we tend to work according to pattern recognition, which is a necessary principle in daily life. However, in the long run as the fetal patient increasingly demands a more dynamic approach to solve the diagnostic riddles, we find ourselves digging deeper into the physiological mechanisms behind ultrasound images and recordings.
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Mosimann, Beatrice, Sofia Amylidi-Mohr, Daniel V. Surbek y Luigi Raio. "Double inferior vena cava in a monochorionic twin pregnancy with selective fetal growth restriction". BMJ Case Reports 14, n.º 3 (marzo de 2021): e240379. http://dx.doi.org/10.1136/bcr-2020-240379.

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Congenital anomalies of the infrarenal inferior vena cava (IVC) are well described in adult life, however, little information exists on their associations in fetal life. Here, we describe a case of a monochorionic diamniotic (MCDA) twin pregnancy complicated by selective fetal growth restriction (sFGR) with an incidental finding of a double IVC in one child. In fetal life, variants of the infrarenal IVC are strongly associated with heart defects, which might suggest haemodynamic alterations or genetic causes, even more so in our case with MCDA twins complicated by sFGR.
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Tiralongo, G. M., I. Pisani, B. Vasapollo, A. Khalil, D. Vinayagam, B. Thilaganathan y H. Valensise. "F4. NO donors and haemodynamic changes in fetal growth restriction". Journal of Maternal-Fetal & Neonatal Medicine 29, sup2 (12 de agosto de 2016): 29. http://dx.doi.org/10.1080/14767058.2016.1234789.

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Fulford, J., S. Dodampahala, S. Vadeyar, S. Francis, P. Baker, D. James y P. Gowland. "Fetal cortical and haemodynamic response to a vibro-acoustic stimulus". NeuroImage 13, n.º 6 (junio de 2001): 880. http://dx.doi.org/10.1016/s1053-8119(01)92222-0.

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Tesis sobre el tema "Fetal haemodynamic"

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Smith, Richard Paul Powell. "The human and ovine fetal haemodynamic and endocrine response to stress". Thesis, Imperial College London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407343.

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Erkinaro, T. (Tiina). "Fetal and placental haemodynamic responses to hypoxaemia, maternal hypotension and vasopressor therapy in a chronic sheep model". Doctoral thesis, University of Oulu, 2006. http://urn.fi/urn:isbn:9514281659.

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Abstract Knowledge of the effects of maternally administered vasopressors on human fetal and placental haemodynamics is sparse and limited to elective Caesarean deliveries in uncomplicated pregnancies. We hypothesized that, after short-term fetal hypoxaemia, which activates fetal cardiovascular compensatory mechanisms, treatment of maternal hypotension with ephedrine or phenylephrine results in divergent responses in fetal and placental haemodynamics. Chronically instrumented near-term sheep fetuses with either normal placental function or increased placental vascular resistance following placental embolization were exposed to two subsequent periods of decreased fetal oxygenation caused by maternal hypoxaemia and epidural-induced hypotension. The fetuses that underwent placental embolization were also chronically hypoxaemic. Fetal and placental haemodynamics were assessed by invasive techniques and by noninvasive Doppler ultrasonography. Our results show that umbilical artery blood flow velocity waveforms cannot be used to derive information of fetal cardiac function. Furthermore, the changes in placental volume blood flows and vascular resistances caused by maternal vasopressor treatment cannot be reliably recognized based on uterine and umbilical artery pulsatility index values. In response to acute hypoxaemia, a fetus with normal placental function redistributes its right ventricular cardiac output from the pulmonary to the systemic circulation and is able to increase its combined cardiac output, with a concomitant relative decrease in the net forward flow through the aortic isthmus. However, fetal haemodynamic responses to subsequent hypoxaemic insults may vary. Furthermore, the compensatory responses of fetuses with increased placental vascular resistance differ from those of normal fetuses. In these fetuses, repeated episodes of a further decrease in oxygenation lead to lactataemia. The effects of ephedrine on uteroplacental and umbilicoplacental circulations were more favourable than those of phenylephrine. Ephedrine restored the changes in fetal cardiovascular haemodynamics caused by maternal hypotension to the baseline conditions in both embolized and nonembolized fetuses. Phenylephrine did not reverse fetal pulmonary vasoconstriction or the relative decrease in the net forward flow through the aortic isthmus. Moreover, fetal left ventricular function was impaired by phenylephrine. Although no significant differences in fetal acid-base status were observed in fetuses with normal placental function, the lactate concentrations of the embolized fetuses increased further when maternal hypotension was treated with phenylephrine.
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Turner, Anita Jillian Medical Sciences Faculty of Medicine UNSW. "Control of renal haemodynamics in the developing kidney - implications for fetal programming". Publisher:University of New South Wales. Medical Sciences, 2008. http://handle.unsw.edu.au/1959.4/41020.

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Renal blood flow and micropuncture studies were conducted in late gestation fetal sheep (gestational age 134 - 141 days; term 150 days) and neonatal lambs (8 - 18 days after birth) to study the forces involved in glomerular filtration (GFR) and characterize the tubuloglomerular feedback (TGF) system during development. These studies required the kidney to be immobilized so stable models in acutely prepared anaesthetized animals were developed. Fetuses were studied in a heated water bath exteriorized from the uterus but with an intact umbilical circulation. The lower GFR in fetuses than lambs was found to be due to both lower net filtration pressures (P<0.001) and a lower ultrafiltration coefficient (P<0.001). TGF was present at both ages, but in fetuses the sensitivity was higher (P<0.001) and reactivity was lower (P<0.001). The reduction in TGF sensitivity between fetal and neonatal life may facilitate the increase in renal blood flow and GFR which occurs at this time. In both fetuses and lambs the sensitivity of the TGF curve was reduced by volume expansion (P<0.001, P<0.05) and reactivity was reduced in lambs (P<0.001). Furosemide abolished TGF at both ages. In both fetuses and lambs, TGF reactivity was increased by inhibition of neuronal nitric oxide synthase (nNOS; P<0.01, P<0.001) and in lambs, TGF sensitivity was increased (P<0.01). This indicates that nitric oxide produced by the macula densa modulates TGF during development. In offspring destined to become hypertensive due to maternal dexamethasone treatment in early gestation TGF sensitivity tended to be enhanced in fetal life and was enhanced in lambs (P<0.01). Increased TGF sensitivity may contribute to the development of hypertension in this model of developmental programming. The effects of nNOS inhibition were attenuated in these animals, suggesting that they have low tonic production of nitric oxide by the macula densa. In fetuses whose mothers had been subtotally nephrectomized prior to mating to induce maternal mild renal impairment, GFR was increased (P<0.01) but net filtration pressure was reduced (P<0.001) so the ultrafiltration coefficient was increased (P<0.001). TGF sensitivity was normal and the effects of nNOS inhibition were similar to normal fetuses.
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Aldrich, Clive Jeffrey. "Intrapartum fetal cerebral oxygenation and haemodynamics assessed by near infrared spectroscopy (NIRS)". Thesis, University of Southampton, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320699.

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Libros sobre el tema "Fetal haemodynamic"

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Räsänen, Juha. Fetal heart and haemodynamics in risk pregnancies and their changes after maternal vasoactive agents: An ultrasonic study. Oulu: [University of Oulu], 1992.

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Dyer, Robert A., Michelle J. Arcache y Eldrid Langesaeter. The aetiology and management of hypotension during spinal anaesthesia for caesarean delivery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0023.

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The management of hypotension during spinal anaesthesia for caesarean delivery remains a challenge for anaesthesiologists. Close control of maternal haemodynamics is of great importance for maternal and fetal safety, as well as maternal comfort. Haemodynamic responses to spinal anaesthesia are influenced by aortocaval compression, the baricity and dose of local anaesthetic and opioid employed, the rational use of fluids, and the goal-directed use of vasopressors. The most common response to spinal anaesthesia is hypotension and an increased heart rate, which reflects a decreased systemic vascular resistance and a partial compensatory increase in cardiac output. Phenylephrine is therefore the vasopressor of choice in this scenario. Less commonly, hypotension and bradycardia may occur, possibly due to the activation of cardiac reflexes. This requires anticholinergics and/or ephedrine. The rarest occurrences are persistent refractory hypotension, or high spinal block with respiratory failure. Special considerations include patients with severe pre-eclampsia, in whom spinal anaesthesia is associated with haemodynamic stability, and less hypotension than in the healthy patient. Careful use of neuraxial anaesthesia in specialized centres has an important role to play in the management of patients with cardiac disease, in conjunction with careful monitoring. Prevention is better than cure, but should hypotension occur, rapid intervention is essential, based upon the exact clinical scenario and individual haemodynamic response.
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Dahl, Vegard y Ulrich J. Spreng. Anaesthesia for non-obstetric surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0010.

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Anaesthesia for non-obstetric reasons is performed in 1–2% of all pregnant women. Although the chances of complications like miscarriage, preterm labour, and abortion are higher when surgery is performed during gestation, careful evaluation, preparation, and a multidisciplinary approach will minimize these risks. There are no methods of anaesthesia that are preferable to others during pregnancy. The most important preventive measure is to maintain maternal haemodynamic stability and normoventilation in order to ensure fetal well-being. Extensive knowledge of the profound anatomical and physiological changes that a pregnancy induces is mandatory for the team when operating on a pregnant woman. Short time exposure to anaesthetic agents in clinically relevant doses during surgery has never been demonstrated to have teratogenic effects. Lately, focus has been made on the possible behavioural teratogenic properties of anaesthesia, especially on the use of NMDA receptor antagonists and GABA receptor agonists. Emergency diagnostic imaging during pregnancy is considered safe and should be performed if necessary. Electroconvulsive therapy for the treatment of serious psychiatric disorders during pregnancy is a possibility that should be considered if necessary. Electric cardioversion seems safe for the fetus if life-threatening arrhythmias occur during pregnancy. Trauma is one of the leading non-obstetric causes of maternal mortality and morbidity. When treating a traumatized pregnant woman one should initially focus on the mother’s safety and haemodynamic stability.
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Archer, Nick y Nicky Manning. Neurodevelopment and fetal cardiac disease. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198766520.003.0026.

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This chapter explores neurodevelopment and fetal cardiac disease, including an introduction and discussion on haemodynamics, specific cardiac lesions, methods of assessment, prevention or limitation, and counselling.
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Toledano, Roulhac D. Physiological changes associated with pregnancy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0002.

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Pregnant patients pose several challenges to anaesthetists and other healthcare providers. Significant systemic and organ-specific changes accompany each stage of pregnancy, culminating during labour and delivery and in the early postpartum period. While healthy parturients tolerate these physiological adaptations to pregnancy well, patients with coexisting disease or pregnancy-related medical conditions may experience acute decompensation, with potential long-term sequelae. Alternatively, symptoms of a disease state may be obscured by pregnancy or mistaken for physiological changes of pregnancy. Anaesthetic management of pregnant patients is further complicated by concerns regarding difficulty with airway management, aspiration of gastric contents, haemodynamic effects of aortocaval compression, maternal obesity, and the effects of volatile agents on uterine tone; reference ranges for laboratory results that differ from those of the non-pregnant population; fears of fetal exposure to antibiotics, analgesics, and anaesthetics; and concerns that more than one patient must be taken into consideration. This chapter reviews the systemic and organ-specific physiological changes that occur during different stages of pregnancy, with a focus on how these adaptations to pregnancy affect anaesthetic management. Familiarity with updated, evidence-based practices and a firm understanding of the physiological changes of pregnancy are essential components of the anaesthetic management of obstetric patients at any gestational age.
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Peacock, Linzi y Rachel Hignett. Acquired heart disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0041.

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Heart disease in pregnancy is a leading cause of maternal death worldwide. In the United Kingdom and United States, heart disease in pregnancy is the commonest cause of maternal death. In Europe, over 1% of maternal deaths are attributable to structural heart disease. In addition, heart disease in pregnancy is a significant cause of severe maternal and fetal morbidity. Whilst the vast majority of women with heart disease in pregnancy have underlying congenital heart disease, most maternal deaths are due to acquired heart disease (AHD). As the risk factors for AHD become ever more prevalent, the expectation is that disease burden from AHD in pregnancy will also increase. Women with AHD benefit from preconception or early assessment in pregnancy by a multidisciplinary team including obstetricians, cardiologists, and obstetric anaesthetists. Risk assessment using the modified World Health Organization classification of cardiac disease in pregnancy will inform frequency of review in pregnancy. A detailed plan for delivery should be agreed in the third trimester. Where possible, a vaginal delivery is advised: caesarean delivery is reserved for women with obstetric indications or with specific severe underlying cardiac conditions. Slow incremental epidural analgesia is usually recommended to reduce the cardiorespiratory work of labour and an assisted second-stage delivery will limit exertion due to pushing. Neuraxial anaesthesia for operative delivery is becoming a more familiar approach and techniques such as low-dose spinal component combined spinal–epidural or slow incremental epidural top-up maximize haemodynamic stability. Invasive monitoring is often beneficial. Post-delivery care is safely delivered in a high dependency or intensive therapy setting. This chapter looks at the general principles of management of women with AHD, and then examines in detail ischaemic heart disease, arrhythmias, cardiac transplantation, aortic pathology and aortic dissection, cardiomyopathy, valvular heart disease, and infective endocarditis.
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Capítulos de libros sobre el tema "Fetal haemodynamic"

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Giménez Mínguez, Paula, Bart Bijnens, Gabriel Bernardino, Èric Lluch, Iris Soveral, Olga Gómez y Patricia Garcia-Canadilla. "Assessment of Haemodynamic Remodeling in Fetal Aortic Coarctation Using a Lumped Model of the Circulation". En Functional Imaging and Modelling of the Heart, 471–80. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-59448-4_45.

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Villanueva, Maria Inmaculada, Marc López, Sergio Sánchez, Patricia Garcia-Cañadilla, Paula C. Randanne, Ameth Hawkins, Elisenda Eixarch et al. "Haemodynamic Changes in the Fetal Circulation Post-connection to an Artificial Placenta: A Computational Modelling Study". En Statistical Atlases and Computational Models of the Heart. Regular and CMRxMotion Challenge Papers, 46–55. Cham: Springer Nature Switzerland, 2022. http://dx.doi.org/10.1007/978-3-031-23443-9_5.

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Bednarek, Szymon, Małgorzata Głogiewicz, Rafał Adamczak y Mariusz Dubiel. "Haemodynamic Changes during Preterm Birth Treatment". En Caesarean Section [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96923.

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The well-being of the fetus depends on the efficiency of its circulatory system and the proper maternal-fetal exchange. Hemodynamic changes can occur due to disturbance of fetal and maternal homeostasis, malformations, pregnancy pathology, and medications. Preterm labor directly affects maternal-fetal haemodynamics, both due to uterine contractions and medications used to inhibit it. Research on maternal-fetal haemodynamics in preterm labor is currently focused mainly on the safety of the used tocolytics. In this chapter, we will discuss the basic principles of fetal haemodynamics, ultrasound methods of maternal-fetal circulation assessment, and the influence of preterm labor on maternal-fetal haemodynamics, with particular emphasis on medications used in threatening and progressive preterm labor.
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Droege, Lisa-Antonia y Wolfgang Henrich. "Gynaecological, obstetric, and neonatological aspects". En ESC CardioMed, editado por Vera Zagrosek-Regitz, 2852–54. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0687.

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Pregnancies in women with cardiopulmonary disease pose a higher risk of maternal cardiovascular events and fetal compromise. Prenatal diagnostics to detect fetal malformations and examination of the fetoplacental haemodynamic state are therefore required.
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Holm, Johan y Bernard Iung. "Management during pregnancy". En ESC CardioMed, editado por Helmut Baumgartner, 1702–4. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0774.

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Physiologic haemodynamic changes during pregnancy carry a risk of cardiac complications in women with valvular disease. Mitral stenosis with valve area <1.5 cm² is poorly tolerated and percutaneous mitral commissurotomy is needed during pregnancy if symptoms persist under medical therapy. The risk of complications is lower with aortic stenosis when women were asymptomatic before pregnancy with preserved left ventricular function. Chronic regurgitations are generally well tolerated, even when severe, provided left ventricular systolic function is preserved. Surgery under cardiopulmonary bypass should be avoided during pregnancy due to the fetal risk. There is a high risk of thromboembolic complications during pregnancy in women with a mechanical prosthesis, leading to maternal mortality between 1-4%. The choice of the modalities of anticoagulant therapy should weigh fetal and maternal risks after careful patient information. Given its complexity and risks, the management of pregnant patients with valvular disease should be performed in multidisciplinary cardiac-obstetric team.
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Kahan, Thomas. "Hypertension in special situations". En ESC CardioMed, editado por Bryan Williams, 2474–78. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0572.

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Hypertensive emergencies are a heterogeneous group of acute hypertensive disorders with very high blood pressure and acute hypertension-mediated organ damage, which require rapid recognition and treatment with the appropriate therapy to avoid progressive organ dysfunction. Key target organs of acute hypertension-mediated organ damage are the heart, retina, brain, kidneys, and large arteries. The type of organ damage will determine the preferred drug, target blood pressure, and the timeframe for blood pressure reduction. Patients without acute hypertension-mediated organ damage do not have a hypertensive emergency. Initial management of acute aortic dissections are directed at haemodynamic stabilization, including rapid reduction of blood pressure to less than 120 mmHg and heart rate to less than 60 beats/min to minimize exposure of the aortic wall to shear stress, always including a beta blocker. Preoperative severe uncontrolled hypertension is associated with an increased rate of perioperative complications and qualifies as the most frequent medical condition for postponing non-cardiac surgery. Pregnancy-related hypertensive disorders are common and are associated with an increased maternal and fetal risk during pregnancy, and an increased long-term maternal risk for future hypertension and cardiovascular disease. Hypertensive heart disease can manifest as cardiac atrial and ventricular arrhythmias, most commonly being atrial fibrillation. Appropriate blood pressure control will reduce incident atrial fibrillation. Anticoagulant therapy is often indicated in hypertensive patients with atrial fibrillation.
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Arnold, J. M., J. Sheddon, P. N. Burns y J. M. Evans. "Non-invasive investigations of fetal and maternal haemodynamics". En Fetal Physiological Measurements, 211–16. Elsevier, 1986. http://dx.doi.org/10.1016/b978-0-407-00450-4.50032-0.

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Piela, Andrzej, Jerzy Kuzniar, Andrzej Skret, Tadeusz Zaczek y Zbigniew Szmigiel. "Echocardiographic assessment of haemodynamics in small-for-gestational age fetuses". En Fetal Physiological Measurements, 29–35. Elsevier, 1986. http://dx.doi.org/10.1016/b978-0-407-00450-4.50007-1.

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"Normal pregnancy". En Oxford Handbook of Obstetrics and Gynaecology, editado por Sally Collins, Sabaratnam Arulkumaran, Kevin Hayes, Kirana Arambage y Lawrence Impey, 1–46. 4a ed. Oxford University PressOxford, 2023. http://dx.doi.org/10.1093/med/9780198838678.003.0001.

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Abstract This chapter covers the basics of a normal pregnancy, starting with taking an obstetric history (including current pregnancy, relevant features, and physical examination of the patient), and going on to engagement of the fetal head, the female pelvis, and the diameters and presenting parts of the fetal head. It goes on to discuss the placenta, with its development in early and later stages, circulation, and essential functions. The physiology of pregnancy is covered, including endocrine, haemodynamics, cardiorespiratory, genital tract and breast, and other changes that occur. Preparing for pregnancy, supplements and lifestyle advice, and general recommended health checks are included, as is diagnosis of pregnancy, dating, and ultrasound assessment of the fetus. Finally, antenatal care is explained, including planning, routine and specific blood tests, and preparing for delivery.
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Panna, Mark, Michael Kaufmann y Jamie Conti. "Atrial fibrillation in pregnancy". En ESC CardioMed, 2240–44. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0529.

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Atrial fibrillation (AF) rarely occurs during pregnancy, and when present usually occurs in the setting of congenital and/or structural heart disease such as mitral stenosis. Haemodynamically unstable patients should undergo emergent direct current cardioversion. In stable patients, rate control should be achieved with a beta blocker and/or digoxin. Rhythm control is considered whenever the risk of ongoing AF is considered high for either the mother or fetus, or in highly symptomatic AF as it restores normal haemodynamics. Direct current cardioversion is relatively safe in pregnancy, although fetal monitoring and facilities capable of performing emergent caesarean section are recommended. Anticoagulation should be considered in pregnant patients with AF at risk for stroke. Warfarin should be avoided during the first trimester due to the risk of embryopathy, and during the last 2–4 weeks of pregnancy due to bleeding risks. Low-molecular-weight heparin (preferentially) or unfractionated heparin may be used during these times. Warfarin or heparin-based products may be considered during other parts of pregnancy after fully discussing the risk and benefits of each specific anticoagulant with patients. Pregnant patients with AF should be treated as high-risk pregnancies.
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