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Pulmonary function during pregnancy in normal women and in patients with cardiopulmonary disease
  1. Kuddusi Gazioglu,
  2. Nolan L. Kaltreider,
  3. Mortimer Rosen,
  4. Paul N. Yu
  1. Cardiology Unit of the Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
  2. Pulmonary Disease Unit of the Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
  3. Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York
  4. Medical Clinic, Strong Memorial Hospital, Rochester, New York
  5. Obstetrical Clinic, Strong Memorial Hospital, Rochester, New York

    Abstract

    Pulmonary function studies were carried out during pregnancy in 8 normal women, in 8 patients with valvular (either mitral or aortic) heart disease, and in 8 patients with chronic pulmonary disease (either emphysema or sarcoidosis). In healthy pregnant women, changes in lung volumes and maximal expiratory flow rates were not significant. Diffusing capacity tended to decrease associated with unchanged pulmonary capillary blood volume. In patients with valvular heart disease, ventilation and oxygen consumption increased toward the term. The patients with mitral valve lesions showed a significant decrease in diffusing capacity with an increase in pulmonary capillary blood volume. In patients wth emphysema, characteristic changes were increasing obstructive functional abnormalities associated with an increase in pulmonary diffusing capacity and pulmonary capillary blood volume. None of these patients, however, had clinical evidence of deterioration of their disease. Patients with sarcoidosis had no appreciable alteration in pulmonary function tests.

    The influence of various factors, such as increased ovarian hormones, ventilation-perfusion relationships, intra-abdominal distension, and cardiac haemodynamics, are discussed in relation to the change in pulmonary diffusing capacity and pulmonary capillary blood volume. From the standpoint of pulmonary function studies we think that patients with mitral heart disease and those with pulmonary emphysema tolerate pregnancy less favourably than normal subjects and patients with sarcoidosis.

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