Dissertação
Resposta hemodinâmica materno-fetal à atividade física isométrica nas hipertensões da gestação
Fecha
2020-10-30Autor
Kavalco, Tatiana Frehner
Institución
Resumen
Objective: to evaluate the maternal-fetal hemodynamic by flow doppler parameters in response pregnant women with chronic systemic arterial hypertension (HAS) and with preeclampsia (PE)
submitted to controlled isometric activity, comparing them with healthy patients. Methods: a crosssectional
experimental study was carried out, with 50 healthy pregnant women (control group), 26
with HAS and 24 with PE, with gestational ages between 26 and 36 weeks, submitted to isometric
effort activity with handgrip dynamometer and had maternal hemodynamic parameters (systolic blood
pressure (PAS), diastolic (PAD), maternal heart rate (FCM) and uterine arteries (AU´s) Doppler) and
fetal (heart rate, umbilical artery (AUm), middle cerebral artery ( MCA) and venous duct Doppler)
verified before, during and after isometry. Results: the data demonstrated that, in the comparison of
the groups, there were higher values in the PAS, PAD and pulsatility (IP), resistance (IR) and
systole/diastole ratios (S/D) of the right and left AU's in pregnant women with PE in the three periods
evaluated, as well as higher numbers in the IP and IR of the ACM in the pre and postisometric work
and S/D of the ACM and FCM higher in the postisometric effort in the PE than in the healthy ones.
When comparing the control group with chronic hypertensive women, PAS remained higher in all
periods, the right AU and ACM indices were higher in pre-isometry, the ACM IP and all AUm indices
were higher during the isometry and FCM and the IP and S/D of AUm remained higher after the
isometry in the group with HAS. In healthy ones, only FCM transisometry was higher than in hypertensive women. In the comparison between the collection times, statistical significance was
obtained for the control group in the increase of PAS and FCM and in the decrease of the left AU
indices from pre to transisometry; in the decrease of PAS and FCM and in the increase of the PI of the
right AU and of all the indices of the left AU from the trans to the postisometry. For the PE group, an
increase in SBP and a decrease in the S / D of the right AU from the pre to the transisometry and the
general variation of the DBP and the increase in the left AU indices from the trans to the post-isometry
were confirmed. . In pregnant women with SAH, the increase in DBP and the decrease in the PI and
IR of the right AU from the pre to the transisometry were ratified, as well as the increase in the PI and
IR of the right AU and of all the indices of the left AU of the trans for post-contraction. Conclusion:
there are higher PA values of pregnant women with PE and HAS, but with most significant increase
from rest to isometry in healthy and PE patients; and with a relevant decrease from isometry to resting
in healthy women. The right AU has greater resistance in patients with PE; with significant decrease
of this resistance from rest to isometry in pregnant women with PE and HAS and with their increased
from effort to rest in healthy and with chronic HAS. The left AU had decreased resistance before
healthy women isometry and its resistance increases significantly post-contraction in all patients. The
fetal hemodynamic parameters did not show significant differences when comparing the before, during
and post-isometry.