Abstract:
There are several well-known medical conditions in which posture and gravity interact with natural history, including pregnancy. In this review, we provide a comprehensive overview of interactions between maternal posture and maternal physiology and pathophysiology at rest during pregnancy. We conducted a systematic literature search of the MEDLINE database and identified 644 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We present a narrative review of the resulting literature and highlight discrepancies, research gaps, and potential clinical implications. We organize the results by organ system and, commencing with the neurological system, proceed in our synthesis generally in the craniocaudal direction, concluding with the skin. The circulatory system warranted our greatest and closest consideration-literature concerning the dynamic interplay between physiology (heart rate, stroke volume, cardiac output, blood pressure, and systemic vascular resistance), pathophysiology (e.g., hypertension in pregnancy), and postural changes provide an intricate and fascinating example of the importance of the subject of this review. Other organ systems discussed include respiratory, renal, genitourinary, gastrointestinal, abdominal, and endocrine. In addition to summarizing the existing literature on maternal posture-physiology interactions, we also point out gaps and opportunities for further research and clinical developments in this area. Overall, our review provides both insight into and relevance of maternal posture-physiology interactions vis à vis healthcare\'s mission to improve health and wellness during pregnancy and beyond.
摘要:
有几种众所周知的医学状况,其中姿势和重力与自然史相互作用,包括怀孕。在这次审查中,我们全面概述了母亲体位与母亲生理和孕期休息时的病理生理之间的相互作用.我们对MEDLINE数据库进行了系统的文献检索,并确定了1991年至2021年的644项研究。符合我们的纳入标准。我们对由此产生的文献进行了叙述性回顾,并强调了差异,研究空白,和潜在的临床意义。我们按器官系统组织结果,从神经系统开始,通常沿颅尾方向进行我们的合成,用皮肤结束。循环系统值得我们最大和最密切的考虑-关于生理之间动态相互作用的文献(心率,每搏输出量,心输出量,血压,和全身血管阻力),病理生理学(例如,妊娠期高血压),和姿势的变化提供了一个复杂而迷人的例子,说明了这篇评论的主题的重要性。讨论的其他器官系统包括呼吸系统,肾,泌尿生殖系统,胃肠,腹部,和内分泌。除了总结有关母亲姿势-生理学相互作用的现有文献外,我们还指出了这方面进一步研究和临床发展的差距和机会。总的来说,我们的综述提供了产妇姿势-生理学相互作用的洞察力和相关性,相对于医疗保健的使命,以改善怀孕期间及以后的健康和健康。