Suscriptores   Asóciese  
Textos Completos Autorizados
A INFLUENCIA DO FUMO NA VIDA FETAL E SEUS EFEITOS AGUDOS NA UNIDADE FETO-MATERNO-PLACENTARIA

v-estudie-lo-mejor.gif
Expertos Invitados





A INFLUENCIA DO FUMO NA VIDA FETAL E SEUS EFEITOS AGUDOS NA UNIDADE FETO-MATERNO-PLACENTARIA

(especial para SIIC © Derechos reservados)
O fumo altera variáveis fisiológicas da circulação feto-materno-placentária mas não modifica a função cardíaca fetal, na dose utilizada de nicotina e seus demais componentes
santosmuller9.jpg Autor:
Janine Santos Müller
Columnista Experto de SIIC
Artículos publicados por Janine Santos Müller
Coautores
Marcelo Antunes.*  Ivo Behle**  Lucas Teixeira***  Paulo Zielinsky**** 
Médico. Instituto de Cardiología do Rio Grande do Sul/FUC.*
Doutor em Obstetríca. Livre-Docente em Obstetrícia USP. Instituto de Cardiología do Rio Grande do Sul/FUC.**
Médico. Unidade de Cardiología Fetal. Instituto de Cardiología do Rio Grande do Sul/FUC.***
Doutor em Cardiología. Instituto de Cardiología do Rio Grande do Sul/FUC.****
Recepción del artículo
19 de Diciembre, 2003 		Primera edición
13 de Agosto, 2004 		Segunda edición, ampliada y corregida
7 de Junio, 2021

A INFLUENCIA DO FUMO NA VIDA FETAL E SEUS EFEITOS AGUDOS NA UNIDADE FETO-MATERNO-PLACENTARIA

Resumen
Objetivo: Estudar as alterações hemodinâmicas agudas na circulação da unidade feto-materno-placentária imediatamente após a exposição da mãe ao fumo. Métodos: A amostra foi constituída de 21 gestantes, fumantes crônicas, mas com evolução normal da gestação. As pacientes foram submetidas a uma avaliação ultra-sonográfica obstétrica e a uma ecocardiografia fetal antes e 5 minutos após fumarem um cigarro, padronizado com 0.5 mg de nicotina e 6 mg de monóxido de carbono após 12 horas de abstinência. Resultados: O número médio de cigarros fumados por dia foi de 9.67. A idade gestacional variou de 18 a 36 semanas. Ocorreu aumento da freqüência cardíaca materna (p < 0.001), da freqüência cardíaca fetal (p = 0.044) e da pressão arterial sistólica(p = 0.004) e diastólica (p = 0.033) maternas imediatamente após o ato de fumar. Houve diminuição da relação S/D nas artérias uterinas direita (p = 0.014) e esquerda (p = 0.039) e as demais variáveis hemodinâmicas não se modificaram. Conclusão: O fumo altera variáveis fisiológicas da circulação feto-materno-placentária mas não modifica a função cardíaca fetal, na dose utilizada de nicotina e seus demais componentes. A diminuição da relação S/D nas artérias uterinas provavelmente está relacionada a um padrão dose-dependente da nicotina.

Palabras clave
Fumo, ecocardiografia fetal, ultra-sonografia obstétrica, fumo materno, trocas materno-fetais


Artículo completo
(castellano)
Extensión:  +/-5.75 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

ACUTE EFFECTS OF SMOKING IN THE HEMODYNAMICS OF FETAL-MATERNAL-PLACENTAL UNIT

Abstract
Objective: To assess acute hemodynamic changes in the fetal-maternal-placental unit after maternal smoking. Methods: The sample was made up by 21 pregnant women who were chronic smokers. The patients were submitted to an obstetric ultrasound evaluation and to a fetal echocardiogram, before and five minutes after smoking a cigarette with 0.5 mg of nicotine and 6mg of carbon monoxide. The patients were asked to not smoke for 12 hour before the test. Results: Mean maternal age was 22.95 years and mean daily cigarette consumption was 9.67. Mean gestational age was 29.29 weeks (18-36 weeks). Maternal heart rate (p < 0.001) and fetal heart rate (p = 0.044) increased after smoking. Maternal systolic blood pressure (p = 0.004) and diastolic blood pressure (p = 0.033) also increased. The S/D ratio decreased in the right uterine artery (p = 0.014) and in the left uterine artery (p = 0.039). The others hemodynamic parameters did not change. Conclusion: Smoking causes alterations in fetal, maternal and placental physiological variables but does not change fetal heart function according to the concentration of nicotine and others components used in this study. The decrease in the S/D ratio of the uterine arteries is probably due to a dose-dependent related effect of nicotine.

Key words
Smoking; fetal echocardiography; obstetric ul, maternal smoking, maternal-fetal exchange

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Medicina Reproductiva, Obstetricia y Ginecología
Relacionadas: Cardiología, Diagnóstico por Imágenes, Pediatría, Toxicología



Comprar este artículo
Extensión: 5.75 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Bibliografía del artículo
  1. Lambers DS, Clark KE - The maternal and fetal physiologic effects of nicotine. Semin Perinatol 1996; 20(2):115-26.
  2. Shah NR, Bracken MB - A systematic review and metanalysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol 2000;182:465-72.
  3. Cnattingius S, Granath F, Petersson G - The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries. N Engl J Med 1999; 341:943-8.
  4. Brooke OG, Anderson HR, Bland JM, et al. - Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress. Br Med J 1989;298:795-801.
  5. Windham GC, Behren JV, Waller K, et al. - Exposure to environmental tobacco smoke and risk of spontaneous abortion. Am J Epidemiol 1999; 149:243-7.
  6. Li CQ, Windsor RA, Perkins L, et al. - The impact on infant birth weight and gestational age of cotinine-validated smoking reduction during pregnancy. JAMA 1993;269(12):1519-24.
  7. Peacock JL, Bland JM, Anderson HR, et al. - Cigarette smoking and birthweight: Type of cigarette smoked and a possible threshold effect. Int J Epidemiol 1991; 20(2):405-12.
  8. Sadler L, Belanger K, Saftlas A, et al. - Environmental tobacco smoke exposure and small-for-gestational-age birth. Am J Epidemiol 1999;150:695-705.
  9. Bernstein IM, Plociennik K, Stahle S, et al – Impact of maternal cigarette smoking on fetal growth and body composition. Am J Obstet Gynecol 2000 Oct; 183(4):883-6.
  10. Vorherr H - Factors influencing fetal growth. Am J Obstet Gynecol 1982;142:577-88.
  11. Gilliland FD, Li YF, Dubeau L, et al – Effects of glutathione S-transferase M1, maternal smoking during pregnancy, and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med 2002 Aug 15;166(4):457-63.
  12. Dwyer T, Ponsonby AL, Couper D - Tobacco smoke exposure at one month of age and subsequent risk of SIDS- A prospective study. Am J Epidemiol 1999;149:593-602.
  13. Slotkin TA, Epps TA, Stenger ML, et al. - Cholinergic receptors in heart and brainstem of rats exposed to nicotine during development: implications for hypoxia tolerance and perinatal mortality. Developmental Brain Research 1999;113:1-12.
  14. Filippini G, Farinotti M, Ferrarini M – Active and passive smoking during pregnancy and risk of central nervous system tumours in children. Paediatr Perinat Epidemiol 2000 Jan; 14(1):78-84.
  15. Adams EK, Miler VP, Ernst C, et al – Neonatal health care costs related to smoking during pregnancy. Health Econ 2002 Apr;11(3):193-206.
  16. Luck W, Nau H, Hansen R, et al. - Extend of nicotine and cotinine transfer to the human fetus, placenta and amniotic fluid of smoking mothers. Dev Pharmacol Ther 1985;8:384-95.
  17. Luck W, Nau H - Nicotine and cotinine concentrations in the serum and milk of nuring smokers. Br J Clin Pharmacol 1984;18:9-15.
  18. Giacomini CB. Cortisol e sulfato de deidroepiandrosterona no sangue de cordão umbilical de recém-nascidos normais de mães fumantes e não-fumantes. [Dissertção]. Porto Alegre: Universidade Federal do Rio Grande do Sul - Curso de Pós-Graduação Medicina: Clínica Médica; 1991.
  19. Coulson CC, Thorp JM, Purrington J, et al - Effects of maternal smoking on amniotic fluid volume and fetal urine output. Am J Perinatol 1996;13(4):195-97.
  20. Ostrea EM, Jr, Knapp DK, Romero A, et al. - Meconium analysis to asses fetal exposure to nicotine by active and passive maternal smoking. J Pediatr 1994;124:471-6.
  21. Eliopoulos C, Klein J,Phan MK, et al. - Hair concentrations of nicotine and cotinine in women and their newborn infants. JAMA 1994;271(8):621-23.
  22. Pichini S, Basagana XB, Pacifici R, et al – Cord serum cotinine as a biomarker of fetal exposure to cigarette smoke at the and of pregnancy. Environ Health Perspect 2000 Nov;108(11):1079-83.
  23. Obwegeser R, Oguogho A, Ulm M, et al. - Maternal cigarette smoking increases F2-isoprostanes and reduces prostacyclin and nitric oxide in umbilical vessels. Prostaglandins and other lipid mediators 1999;57:269-79.
  24. Gruslin A, Perkins SL, Manchanda R, et al – Maternal smoking and fetal erythropoietin levels. Obstet Gynecol 2000 Apr;95(4):561-4.
  25. Morrow RJ, Ritchie JWK, Bull SB - Maternal cigarette smoking: The effects on umbilical and uterine blood flow velocity. Am J Obstet Gynecol 1988;159:1069-71.
  26. Lindblad A, Marsal K, Andersson KE - Effect of nicotine on human fetal blood flow. Obstet Gynecol 1988;72(3);371-82.
  27. Newnham JP, Patterson L, James I, et al. - Effects of maternal cigarette smoking on ultrasonic measurements of fetal growth and on Doppler flow velocity waveforms. Early Hum Devel.1990;24:23-36.
  28. Coppens M, Vindla S, Aames DK, et al – Computerized analysis of acute and chronic changes in fetal heart rate variation and fetal activity in association with maternal smoking. Am J Obstet Gynecol 2001 Aug;185(2):421-6.
  29. Oncken CA, Hardardottir H, Hatsukami DK, et al. - Effects of transdermal nicotine or smoking on nicotine concentrations and maternal-fetal hemodynamics. Obstet Gynecol 1998;90(4): 569-74.
  30. Zielinsky P, Hagemann LL, Zimmer LP, Ceccon G, Bonow FP, Oliveira LT - O papel da ultra-sonografia obstétrica de rotina no diagnóstico presuntivo de cardiopatias fetais. Revista AMRIGS 1997;41(4):181-86.
  31. Zielinsky P - Abordagem diagnóstica e terapêutica pré-natal das anormalidades cardíacas fetais. ECO Rev Bras Ecocardiogr 1992;17:10-25.
  32. Firpo C, Zielinsky P - Mobility of the septum primum in the developing human fetus. Cardiol Young 1998;8(1):67-70.
  33. Firpo C, Zielinsky P- Behaviour of the "Septum Primum" Mobility in Third Trimester Fetuses With Myocardial Hypertrophy. Ultrasound Obstetr Gynecol 2003;21:445-450.
  34. Clark KE, Irion GL - Fetal hemodynamic response to maternal intravenous nicotine administration. Am J Obstet Gynecol,1992;167(6)1624-31.
  35. Salafia C, Shiverick K - Cigarette smoking and pregnancy II: Vascular effects. Placenta 1999;20:273-79.
  36. Zhang J, Klebanoff MA, Levine RJ, et al. - The puzzling association between smoking and hypertension during pregnancy. Am J Obstet Gynecol 1999;181:1407-13.
  37. Terborg C, Bramer S, WeillerC, et al – Short-term effect of cigarette smoking on CO(2)-induced vasomotor reactivity in man: a study with near-infrared spectroscopy and transcranial Doppler sonography. J Neurol Sci 2002 Dec 15;205(1):15-20.
  38. Alam M, Samad BA, Wardell J, et al – Acute effects of smoking on diastolic function in healthy participants: studies by conventional Doppler echocardiography and Doppler tissue imaging. J Am Soc Echocardiogr 2002 Oct;15(10 Pt 2):1232-7.
  39. Mattos SS - O Coração Fetal. Rio de Janeiro: Revinter,1999.
  40. DeVore GR - Assessment of venous flow in normal and high-risk fetuses: is the future now Prenat Neonat Med 1996;1;329-42.
  41. Hecher K, Campbell S - Characteristics of fetal venous blood flow under normal circunstances and during fetal disease. Ultrasound Obtet Gynecol 1996;7:68-83.
Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

 English title
 Abstract
 Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia

Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Acerca de SIIC   Estructura de SIIC   Fuentes informativas  

Sociedad Iberoamericana de Información Científica

Copyright siicsalud© 1997-2024 ISSN siicsalud: 1667-9008
ua31517