Advertisement

The Normal Physiology of Pregnancy: Neurological Implications

  • Cesar R. Padilla
  • Nicole A. SmithEmail author
Chapter

Abstract

Physiologic changes in pregnancy encompass a wide variety of organ system adaptations that support the developing fetus and prepare the mother’s body for childbirth. Some physiologic changes mimic pathologic changes, while others put mothers at risk for medical complications. In the following chapter we highlight pertinent changes in maternal physiology by organ system and how these changes contribute to common neurologic disease states.

Keywords

Maternal physiology Maternal health Neurological disease in pregnancy Physiology of pregnancy 

References

  1. 1.
    Gaiser R. Chestnut’s obstetric anesthesia: principles and practice, fifth edition: physiologic changes in pregnancy fifth edition ed. Philadelphia; Elsevier. 2014.Google Scholar
  2. 2.
    Bernstein IM, Ziegler W, Badger GJ. Plasma volume expansion in early pregnancy. Obstet Gynecol. 2001;97(5 Pt 1):669–72.PubMedGoogle Scholar
  3. 3.
    de Haas S, Ghossein-Doha C, van Kuijk SM, van Drongelen J, Spaanderman ME. Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;49(2):177–87.PubMedCrossRefGoogle Scholar
  4. 4.
    Gerbasi FR, Bottoms S, Farag A, Mammen E. Increased intravascular coagulation associated with pregnancy. Obstet Gynecol. 1990;75(3 Pt 1):385–9.PubMedGoogle Scholar
  5. 5.
    Robson SC, Hunter S, Moore M, Dunlop W. Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol. 1987;94(11):1028–39.PubMedCrossRefGoogle Scholar
  6. 6.
    Dunlop W. Serial changes in renal haemodynamics during normal human pregnancy. Br J Obstet Gynaecol. 1981;88(1):1–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Sims EA, Krantz KE. Serial studies of renal function during pregnancy and the puerperium in normal women. J Clin Invest. 1958;37(12):1764–74.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    West CA, Sasser JM, Baylis C. The enigma of continual plasma volume expansion in pregnancy: critical role of the renin-angiotensin-aldosterone system. Am J Physiol Ren Physiol. 2016;311(6):F1125–34.CrossRefGoogle Scholar
  9. 9.
    Barron WM, Durr JA, Schrier RW, Lindheimer MD. Role of hemodynamic factors in osmoregulatory alterations of rat pregnancy. Am J Phys. 1989;257(4 Pt 2):R909–16.Google Scholar
  10. 10.
    Irons DW, Baylis PH, Davison JM. Effect of atrial natriuretic peptide on renal hemodynamics and sodium excretion during human pregnancy. Am J Phys. 1996;271(1 Pt 2):F239–42.Google Scholar
  11. 11.
    Sabers A, Tomson T. Managing antiepileptic drugs during pregnancy and lactation. Curr Opin Neurol. 2009;22(2):157–61.PubMedCrossRefGoogle Scholar
  12. 12.
    Tomson T, Palm R, Kallen K, et al. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation. Epilepsia. 2007;48(6):1111–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Karlsson O, Sporrong T, Hillarp A, Jeppsson A, Hellgren M. Prospective longitudinal study of thromboelastography and standard hemostatic laboratory tests in healthy women during normal pregnancy. Anesth Analg. 2012;115(4):890–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Institute of Medicine. Iron deficiency anemia: Recommended guidelines for the prevention, detection, and management among US children and women of childbearing age. https://www.nap.edu/catalog/2251/iron-deficiency-anemia-recommended-guidelines-for-the-prevention-detection-and. Accessed on 22 Nov 2017.
  15. 15.
    American College of O, Gynecologists’ Committee on Practice B-O. Practice bulletin no. 166: thrombocytopenia in pregnancy. Obstet Gynecol. 2016;128(3):e43–53.CrossRefGoogle Scholar
  16. 16.
    Samuels P, Bussel JB, Braitman LE, et al. Estimation of the risk of thrombocytopenia in the offspring of pregnant women with presumed immune thrombocytopenic purpura. N Engl J Med. 1990;323(4):229–35.PubMedCrossRefGoogle Scholar
  17. 17.
    Thornton P, Douglas J. Coagulation in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2010;24(3):339–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Bateman BT, Olbrecht VA, Berman MF, Minehart RD, Schwamm LH, Leffert LR. Peripartum subarachnoid hemorrhage: nationwide data and institutional experience. Anesthesiology. 2012;116(2):324–33.PubMedCrossRefGoogle Scholar
  19. 19.
    Bader A. Chestnut’s obstetric anesthesia: principles and practice, 5th edition: neurologic and neuromuscular disease. Philadelphia; Elsevier. 2014.CrossRefGoogle Scholar
  20. 20.
    Ng J, Kitchen N. Neurosurgery and pregnancy. J Neurol Neurosurg Psychiatry. 2008;79(7):745–52.PubMedCrossRefGoogle Scholar
  21. 21.
    Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med. 2005;352(17):1791–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Saposnik G, Barinagarrementeria F, Brown RD Jr, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(4):1158–92.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Suresh M. Shnider and Levinson’s anesthesia for obstetrics. Lippincott Williams &Wilkins; 2013.Google Scholar
  24. 24.
    Lafitte F, Boukobza M, Guichard JP, et al. MRI and MRA for diagnosis and follow-up of cerebral venous thrombosis (CVT). Clin Radiol. 1997;52(9):672–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F, Investigators I. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35(3):664–70.PubMedCrossRefGoogle Scholar
  26. 26.
    Kaplan PW, Norwitz ER, Ben-Menachem E, et al. Obstetric risks for women with epilepsy during pregnancy. Epilepsy Behav. 2007;11(3):283–91.PubMedCrossRefGoogle Scholar
  27. 27.
    Harden CL, Hopp J, Ting TY, et al. Practice parameter update: management issues for women with epilepsy – focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the quality standards subcommittee and therapeutics and technology assessment subcommittee of the american academy of neurology and american epilepsy society. Neurology. 2009;73(2):126–32.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Edey S, Moran N, Nashef L. SUDEP and epilepsy-related mortality in pregnancy. Epilepsia. 2014;55(7):e72–4.PubMedCrossRefGoogle Scholar
  29. 29.
    Nau H, Kuhnz W, Egger HJ, Rating D, Helge H. Anticonvulsants during pregnancy and lactation. Transplacental, maternal and neonatal pharmacokinetics. Clin Pharmacokinet. 1982;7(6):508–43.PubMedCrossRefGoogle Scholar
  30. 30.
    Tomson T, Battino D. Teratogenic effects of antiepileptic drugs. Lancet Neurol. 2012;11(9):803–13.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Hernandez-Diaz S, Smith CR, Shen A, Mittendorf R, Hauser WA, Yerby M, Holmes LB, North American AED Pregnancy Registry; North American AED Pregnancy Registry. Comparative safety of antiepileptic drugs during pregnancy. Neurology. 2012;78(21):1692–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Brigham and Women’s HospitalBostonUSA
  2. 2.Maternal Fetal MedicineBrigham and Women’s HospitalBostonUSA
  3. 3.Department of ob/gynBrigham and Women’s HospitalBostonUSA

Personalised recommendations