Cardiopulmonary Changes In Pregnant Women In Sabon-Gari Local Government Area, Of Kaduna State, Nigeria

摘要

The cardiopulmonary changes among pregnant women were studied in 400 subjects (100 non-pregnant and 300 pregnant). The cardiovascular parameters measured are blood pressure (systolic and diastolic), pulse rate and mean arterial blood pressure by auscultatory method using stethoscope and sphygmomanometer. The pulmonary parameters measured are peak expiratory flow rate (PEFR), using Wright peak flow meter and respiratory rate the number times thoracic cage expands and relaxes. The cardiopulmonary parameters of pregnant women decreased significantly (p<.05) when compared to non-pregnant. The anthropometric parameters in first trimester when compared to the control group did not decrease significantly (P>0.05), while in second and third trimester the anthropometric parameters decreases significantly (p<.05) with positive correlation when compared to control. The cardiopulmonary parameters in pregnant women showed a significant changes (p<.05) when compare to non-pregnant. Introduction The physiologic, biochemical and anatomical changes that occur during pregnancy are extensive and may be systemic or local (15). Teleological alterations during pregnancy maintain a healthy environment for the fetus without compromising the mother`s health (16). Although, sometimes determine small discomfort to the mother. During pregnancy, significant cardiovascular and pulmonary changes occur, which alters the cardiopulmonary parameters (7) like the blood volume, heart rate, stroke volume, cardiac output, lung volumes and minute ventilation (1). Understanding and appreciating (8) the normal physiologic adaptations to gestation are important for accessing health status of the pregnant women (11). Hormonal changes in pregnancy affect the upper respiratory tract and airway mucosa, producing hyperemia, mucosal edema, hypersecretion, and increased mucosal friability (14). Estrogen is probably responsible for producing tissue edema, capillary congestion, and hyperplasia of mucous glands. The enlarging uterus and the hormonal effects produce anatomical changes to the thoracic cage. As the uterus expands, the diaphragm is displaced cephalic by as much as 4 cm; an increase in the anteroposterior diameter and transverse diameter of the thorax occurs, increasing the chest wall circumference (16). Hormonal changes do not significantly affect airway function; pregnancy does not appear to change lung compliance, but chest wall and total respiratory compliance are reduced at term (13, 18). In light of this, the study is designed to evaluate the cardiovascular and pulmonary changes in pregnant women so that we can establish a baseline in this part of the world. We hypothesized that pregnancy would be associated with changes in cardiopulmonary functions. Materials And Methods Materials: The following materials were used for the test; peak flow meter (S48917 Vitalograph Ltd Buckingham, England), weighing scale, measuring tape, sphygmomanometer, stethoscope, stopwatch, cotton wool, disinfectant (methylated spirit) and subjects (100 non-pregnant women and 300 pregnant women). Data collection: The study was compiled with the ethical committee guidelines of Ahmadu Bello University Teaching Hospital, Zaria and the procedures followed were in accord with the ethical standards of Ahmadu Bello University, Zaria, Nigeria. The data of 400 female subjects (100 non pregnant and 300 pregnant) was collected using a questionnaire in Sabon Gari local government in antenatal clinics of Kaduna state, Nigeria. The data collected from all the subjects with an age range of 25-40 years by random sampling are; age (years), weight (kg), height (m), body mass index (BMI), blood pressure (mmHg), pulse pressure (mmHg), heart rate (beat/min), peak expiratory flow rate (PEFR; L/min), mean arterial blood pressure (mmHg) and respiratory rate (breath/min). Climate of the research area; The research was carried out in Zaria with the following climatic conditions: mean annual rainfall 1000mm, mean a