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

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

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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

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

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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



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