■ Memory
Changes in the central nervous center are relatively few and mostly subtle. Women often report problems with attention, concentration, and memory throughout pregnancy and the early puerperium. Systematic studies of memory in pregnancy, however, are limited and often anecdotal. Keenan and associates (1998) longitudinally investigated memory in pregnant women and a matched control group. They found pregnancy-related memory decline, which was limited to the third trimester. This decline was not attributable to depression, anxiety, sleep depri- vation, or other physical changes associated with pregnancy. It was transient and quickly resolved following delivery. Henry and Sherwin (2012) also reported that pregnant women in late pregnancy performed significantly worse on tests of verbal recall and processing speed compared with matched nonpreg- nant controls. Interestingly, Rana and colleagues (2006) found that attention and memory were improved in women with pre- eclampsia receiving magnesium sulfate compared with normal pregnant women.
Zeeman and coworkers (2003) used magnetic resonance imag- ing to measure cerebral blood flow across pregnancy in 10 healthy women. They found that mean blood flow in the middle and posterior cerebral arteries decreased progressively from 147 and 56 mL/min when nonpregnant to 118 and 44 mL/min late in pregnancy, respectively. The mechanism and clinical significance of this decline is unknown. Pregnancy does not appear to affect cerebrovascular autoregulation (Bergersen, 2006; Cipolla, 2014).
■ Eyes
Intraocular pressure decreases during pregnancy and is attrib- uted in part to increased vitreous outflow (Sunness, 1988).
Corneal sensitivity is decreased, and the greatest changes are late in gestation. Most pregnant women demonstrate a measurable but slight increase in corneal thickness, thought to be due to edema. Consequently, they may have difficulty with previously comfortable contact lenses. Brownish-red opacities on the poste- rior surface of the cornea—Krukenberg spindles— ss—have also been observed with a higher than expected frequency during preg- nancy. Hormonal effects similar to those observed for skin lesions are postulated to cause this increased pigmentation. Other than transient loss of accommodation reported with both pregnancy and lactation, visual function is unaffected by pregnancy. These changes during pregnancy, as well as pathological eye aberra- tions, were recently reviewed by Grant and Chung (2013).
■ Sleep
Beginning as early as approximately 12 weeks’ gestation and extending through the first 2 months postpartum, women have difficulty with going to sleep, frequent awakenings, fewer hours of night sleep, and reduced sleep efficiency (Pavlova, 2011). The frequency and duration of sleep apnea episodes were reported to be decreased significantly in pregnant women compared with those postpartum (Trakada, 2003). In the supine position, however, average Pao2 levels were lower.
The greatest disruption of sleep is encountered postpartum and may contribute topostpartum bluessor to frank depression (Chap. 61, p. 1205).
REFERENCES
Ajne G, Ahlborg G, Wolff K, Nisell H: Contribution of endogenous endothelin-1 to basal vascular tone during normal pregnancy and preeclampsia. Am J Obstet Gynecol 193:234, 2005
Alvarez H, Caldeyro-Barcia R: Contractility of the human uterus recorded by new methods. Surg Gynecol Obstet 91:1, 1950
Amoah C, Yassin A, Cockayne E, et al: Hyperreactio luteinalis in pregnancy.
Fertil Steril 95(7):2429.e1, 2011
Andersen JR: Prolactin in amniotic fluid and maternal serum during uncom- plicated human pregnancy. Dan Med Bull 29:266, 1982
Anderson BL, Mendez-Figueroa H, Dahlke J, et al: Pregnancy-induced changes in immune protection of the genital tract: defining normal. Am J Obstet Gynecol 208(4):321.e1, 2013
Andersson S, Minjarez D, Yost NP, et al: Estrogen and progesterone metab- olism in the cervix during pregnancy and parturition. J Clin Endocrinol Metab 93(6):2366, 2008
Antevski B, Jovkovski O, Filipovski V, et al: Extreme gigantomastia in preg- nancy: case report—my experience with two cases in last 5 years. Arch Gynecol Obstet 284(3):575, 2011
Ashoor G, Kametas NA, Akolekar R, et al: Maternal thyroid function at 11–13 weeks of gestation. Fetal Diagn Ther 27(3):156, 2010
Assali NS, Dilts PV, Pentl AA, et al: Physiology of the placenta. In Assali NS (ed): Biology of Gestation, Vol I. The Maternal Organism. New York, Academic Press, 1968
Assali, NS, Douglas RA, Baird WW: Measurement of uterine blood flow and uterine metabolism. IV. Results in normal pregnancy. Am J Obstet Gynecol 66(2):248, 1953
August P, Mueller FB, Sealey JE, et al: Role of renin–angiotensin system in blood pressure regulation in pregnancy. Lancet 345:896, 1995
Avsar AF, Keskin HL: Haemorrhoids during pregnancy. J Obstet Gynaecol 30(3):231, 2010
Bailey RR, Rolleston GL: Kidney length and ureteric dilatation in the puerpe- rium. J Obstet Gynaecol Br Commonw 78:55, 1971
Baksu B, Davas I, Baksu A, et al: Plasma nitric oxide, endothelin-1 and uri- nary nitric oxide and cyclic guanosine monophosphate levels in hypertensive pregnant women. Int J Gynaecol Obstet 90:112, 2005
Bamber JH, Dresner M: Aortocaval compression in pregnancy: the effect of changing the degree and direction of lateral tilt on maternal cardiac output.
Anesth Analg 97:256, 2003
Bardicef M, Bardicef O, Sorokin Y, et al: Extracellular and intracellular magne- sium depletion in pregnancy and gestational diabetes. Am J Obstet Gynecol 172:1009, 1995
Batukan C, Tuncay-Ozgun M, Turkyilmaz C, et al: Isolated torsion of the fallopian tube during pregnancy: a case report. J Reprod Med 52:745, 2007 Baykus Y, Gurates B, Aydin S, et al: Changes in serum obestatin, preptin
and ghrelins in patients with gestational diabetes mellitus. Clin Biochem 45(3):198, 2012
Bentley-Lewis R, Graves SW, Seely EW: The renin-aldosterone response to stimulation and suppression during normal pregnancy. Hypertens Pregnancy 24(1):1, 2005
Berger MH, Betschart C, Khandwala N, et al: Incidental Bartholin gland cysts identified on pelvic magnetic resonance imaging. Obstet Gynecol 120(4):
798, 2012
Bergersen TK, Hartgill TW, Pirhonen J: Cerebrovascular response to normal pregnancy: a longitudinal study. Am J Physiol Heart Circ Physiol 290:1856, 2006
Bernstein IM, Ziegler W, Badger GJ: Plasma volume expansion in early preg- nancy. Obstet Gynecol 97:669, 2001
Bieniarz J, Branda LA, Maqueda E, et al: Aortocaval compression by the uterus in late pregnancy, 3. Unreliability of the sphygmomanometric method in estimating uterine artery pressure. Am J Obstet Gynecol 102:1106, 1968 Bloom SL, Uppot R, Roberts DJ: Case 32–2010: a pregnant woman with abdom-
inal pain and fluid in the peritoneal cavity. N Engl J Med 363(17):1657, 2010 Bobrowski RA: Pulmonary physiology in pregnancy. Clin Obstet Gynecol 53(2):
286, 2010
Boehlen F, Hohlfeld P, Extermann P, et al: Platelet count at term pregnancy: a reappraisal of the threshold. Obstet Gynecol 95:29, 2000
Brar HS, Platt LD, DeVore GR, et al: Qualitative assessment of maternal uter- ine and fetal umbilical artery blood flow and resistance in laboring patients by Doppler velocimetry. Am J Obstet Gynecol 158:952, 1988
CHAPTER 4
Braverman DZ, Johnson ML, Kern F Jr: Effects of pregnancy and contracep- tive steroids on gallbladder function. N Engl J Med 302:362, 1980 Brown MA, Gallery EDM, Ross MR, et al: Sodium excretion in normal and
hypertensive pregnancy: a prospective study. Am J Obstet Gynecol 159:297, 1988
Brown MA, Sinosich MJ, Saunders DM, et al: Potassium regulation and pro- gesterone–aldosterone interrelationships in human pregnancy: a prospective study. Am J Obstet Gynecol 155:349, 1986
Browne JCM, Veall N: The maternal placental blood flow in normotensive and hypertensive women. J Obstet Gynaecol Br Emp 60(2):141, 1953 Brunton PJ, Russell JA: Endocrine induced changes in brain function during
pregnancy. Brain Res 1364:198, 2010
Burns R, Azizi F, Hedayati M, et al: Is placental iodine content related to dietary iodine intake? Clin Endocrinol 75(2):261, 2011
Burrow GN, Fisher DA, Larsen PR: Maternal and fetal thyroid function.
N Engl J Med 331:1072, 1994
Butte NF: Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr 7:1256S, 2000 Carr BR, Parker CR Jr, Madden JD, et al: Maternal plasma adrenocorticotro-
pin and cortisol relationships throughout human pregnancy. Am J Obstet Gynecol 139:416, 1981
Cetin I, de Santis MS, Taricco E, et al: Maternal and fetal amino acid concen- trations in normal pregnancies and in pregnancies with gestational diabetes mellitus. Am J Obstet Gynecol 192:610, 2005
Chellakooty M, Vangsgaard K, Larsen T, et al: A longitudinal study of intrauterine growth and the placental growth hormone (GH)–insulin- like growth factor I axis in maternal circulation. J Clin Endocrinol Metab 89:384, 2004
Chesley LC: Renal function during pregnancy. In Carey HM (ed): Modern Trends in Human Reproductive Physiology. London, Butterworth, 1963 Cipolla MJ, Zeeman GG, Cunningham FG: Cerebrovascular (patho)physiol-
ogy in preeclampsia/eclampsia. In Taylor RN, Roberts JM, Cunningham FG (eds): Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press, 2014
Clapp JF III, Little KD, Widness JA: Effect of maternal exercise and fetopla- cental growth rate on serum erythropoietin concentrations. Am J Obstet Gynecol 188:1021, 2003
Clapp JF III, Stepanchak W, Tomaselli J, et al: Portal vein blood flow—effects of pregnancy, gravity, and exercise. Am J Obstet Gynecol 183:167, 2000 Clark SL, Cotton DB, Lee W, et al: Central hemodynamic assessment of nor-
mal term pregnancy. Am J Obstet Gynecol 161:1439, 1989
Clerico A, Emdin M: Diagnostic accuracy and prognostic relevance of the measurement of cardiac natriuretic peptides: a review. Clin Chem 50:33, 2004
Coccia ME, Pasquini L, Comparetto C, et al: Hyperreactio luteinalis in a woman with high-risk factors: a case report. J Reprod Med 48:127, 2003 Combes B, Adams RH: Disorders of the liver in pregnancy. In Assali NS (ed):
Pathophysiology of Gestation, Vol I. New York, Academic Press, 1971 Connolly TP, Evans AC: Atypical Papanicolaou smear in pregnancy. Clin Med
Res 3:13, 2005
Conrad KP: Emerging role of relaxin in the maternal adaptations to normal pregnancy: implications for preeclampsia. Semin Nephrol 31(1):15, 2011a Conrad KP, Baker VL: Corpus luteal contribution to maternal pregnancy
physiology and outcomes in assisted reproductive technologies. Am J Physiol Regul Integr Comp Physiol 304(2):R69, 2013
Conrad KP, Gaber LW, Lindheimer MD: The kidney in normal pregnancy and preeclampsia. In Taylor RN, Roberts JM, Cunningham FG (eds): Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press, 2014
Conrad KP, Jeyabalan A, Danielson LA, et al: Role of relaxin in maternal renal vasodilation of pregnancy. Ann N Y Acad Sci 1041:147, 2005
Conrad KP, Shroff SG: Effects of relaxin on arterial dilation, remodeling, and mechanical properties. Curr Hypertens Rep 13(6):409, 2011b
Cooper MS: Disorders of calcium metabolism and parathyroid disease. Best Pract Res Clin Endocrinol Metab 25(6):975, 2011
Cornelis T, Odutayo A, Keunen J, et al: The kidney in normal pregnancy and preeclampsia. Semin Nephrol 31(1):4, 2011
Crisp WE, DeFrancesco S: The hand syndrome of pregnancy. Obstet Gynecol 23:433, 1964
Csapo AI, Pulkkinen MO, Wiest WG: Effects of luteectomy and progester- one replacement therapy in early pregnant patients. Am J Obstet Gynecol 115(6):759, 1973
Cunningham FG: Peripartum cardiomyopathy: we’ve com a long way, but . . . Obstet Gynecol 120(5):992, 2012
Cunningham FG, Cox K, Gant NF: Further observations on the nature of pressor responsivity to angiotensin II in human pregnancy. Obstet Gynecol 46:581, 1975
Cutforth R, MacDonald CB: Heart sounds and murmurs in pregnancy. Am Heart J 71:741, 1966
Darmady JM, Postle AD: Lipid metabolism in pregnancy. Br J Obstet Gynaecol 89:211, 1982
Dashe JS, Casey BM, Wells CE, et al: Thyroid-stimulating hormone in single- ton and twin pregnancy: importance of gestational age-specific reference ranges. Obstet Gynecol 106:753, 2005
Davison JM, Dunlop W: Renal hemodynamics and tubular function in normal human pregnancy. Kidney Int 18:152, 1980
Davison JM, Hytten FE: Glomerular filtration during and after pregnancy.
J Obstet Gynaecol Br Commonw 81:588, 1974
Davison JM, Vallotton MB, Lindheimer MD: Plasma osmolality and urinary concentration and dilution during and after pregnancy: evidence that lat- eral recumbency inhibits maximal urinary concentrating ability. Br J Obstet Gynaecol 88:472, 1981
Delorme MA, Burrows RF, Ofosu FA, et al: Thrombin regulation in mother and fetus during pregnancy. Semin Thromb Hemost 18:81, 1992 Duvekot JJ, Cheriex EC, Pieters FA, et al: Early pregnancy changes in hemody-
namics and volume homeostasis are consecutive adjustments triggered by a primary fall in systemic vascular tone. Am J Obstet Gynecol 169:1382, 1993 Easterling TR, Schmucker BC, Benedetti TJ: The hemodynamic effects of
orthostatic stress during pregnancy. Obstet Gynecol 72:550, 1988 Edman CD, Devereux WP, Parker CR, et al: Placental clearance of mater-
nal androgens: a protective mechanism against fetal virilization. Abstract 112 presented at the 26th annual meeting of the Society for Gynecologic Investigation, San Diego, 1979. Gynecol Invest 67:68, 1979
Edman CD, Toofanian A, MacDonald PC, et al: Placental clearance rate of maternal plasma androstenedione through placental estradiol formation:
an indirect method of assessing uteroplacental blood flow. Am J Obstet Gynecol 141:1029, 1981
Enein M, Zina AA, Kassem M, et al: Echocardiography of the pericardium in pregnancy. Obstet Gynecol 69:851, 1987
Farage MA, Maibach HI: Morphology and physiological changes of genital skin and mucosa. Curr Probl Dermatol 40:9, 2011
Feldt-Rasmussen U, Mathiesen ER: Endocrine disorders in pregnancy: physi- ological and hormonal aspects of pregnancy. Best Pract Res Clin Endocrinol Metab 25(6):875, 2011
Feletou M, Vanhoutte PM: Endothelial dysfunction: a multifaceted disorder (The Wiggers Award Lecture). Am J Physiol Heart Circ Physiol 291:H985, 2006
Freemark M: Regulation of maternal metabolism by pituitary and placental hormones: roles in fetal development and metabolic programming. Horm Res 65:41, 2006
Freinkel N: Banting Lecture 1980: Of pregnancy and progeny. Diabetes 29:1023, 1980
Freinkel N, Dooley SL, Metzger BE: Care of the pregnant woman with insulin- dependent diabetes mellitus. N Engl J Med 313:96, 1985
Friedman SA: Preeclampsia: a review of the role of prostaglandins. Obstet Gynecol 71:122, 1988
Fuglsang J: Ghrelin in pregnancy and lactation. Vitam Horm 77:259, 2008 Fuglsang J, Sandager P, Moller N, et al: Kinetics and secretion of placental
growth hormone around parturition. Eur J Endocrinol 154:449, 2006 Galan HL, Marconi AM, Paolini CL, et al: The transplacental transport of
essential amino acids in uncomplicated human pregnancies. Am J Obstet Gynecol 200(1):91.e1–7, 2009
Gallery ED, Raftos J, Gyory AZ, et al: A prospective study of serum comple- ment (C3 and C4) levels in normal human pregnancy: effect of the develop- ment of pregnancy-associated hypertension. Aust N Z J Med 11:243, 1981 Gambling L, Lang C, McArdle HJ: Fetal regulation of iron transport during
pregnancy. Am J Clin Nutr 94(6 Suppl):1903S, 2011
Gant NF, Chand S, Whalley PJ, et al: The nature of pressor responsiveness to angiotensin II in human pregnancy. Obstet Gynecol 43:854, 1974 Gant NF, Daley GL, Chand S, et al: A study of angiotensin II pressor response
throughout primigravid pregnancy. J Clin Invest 52:2682, 1973
Garfield RE, Maner WL, MacKay LB, et al: Comparing uterine electromyogra- phy activity of antepartum patients versus term labor patients. Am J Obstet Gynecol 193:23, 2005
Gayer G, Ben Ely A, Maymon R, et al: Enlargement of the spleen as an inci- dental finding on CT in post-partum females with fever. Br J Radiol 85 (1014):753, 2012
Gennari-Moser C, Khankin EV, Schüller S, et al: Regulation of placental growth by aldosterone and cortisol. Endocrinology 152(1):263, 2011 George EM, Granger JP: Endothelin: key mediator of hypertension in pre-
eclampsia. Am J Hypertens 24(9):964, 2011
Gherman RB, Mestman JH, Satis AJ, et al: Intractable hyperemesis gravi- darum, transient hyperthyroidism and intrauterine growth restriction associ- ated with hyperreactio luteinalis. A case report. J Reprod Med 48:553, 2003
74 Maternal Anatomy and Physiology
SECTION 2
Ghio A, Bertolotto A, Resi V, et al: Triglyceride metabolism in pregnancy. Adv Clin Chem 55:133, 2011
Girling JC, Dow E, Smith JH: Liver function tests in preeclampsia: importance of comparison with a reference range derived for normal pregnancy. Br J Obstet Gynaecol 104:246, 1997
Glinoer D, de Nayer P, Bourdoux P, et al: Regulation of maternal thyroid dur- ing pregnancy. J Clin Endocrinol Metab 71:276, 1990
Gonzalez JG, Elizondo G, Saldivar D, et al: Pituitary gland growth during normal pregnancy: an in vivo study using magnetic resonance imaging. Am J Med 85:217, 1988
Grant AD, Chung SM: The eye in pregnancy: ophthalmologic and neuro- ophthalmologic changes. Clin Obstet Gynecol 56(2):397, 2013
Grindheim G, Toska K, Estensen M-E, et al: Changes in pulmonary function during pregnancy: a longitudinal cohort study. BJOG 119(1):94, 2012 Grummer MA, Sullivan JA, Magness RR, et al: Vascular endothelial growth
factor acts through novel, pregnancy-enhanced receptor signaling pathways to stimulate endothelial nitric oxide synthase activity in uterine artery endo- thelial cells. Biochem J 417(2):501, 2009
Guyton AC (ed): Textbook of Medical Physiology. Philadelphia, W. B.
Saunders Company, 1981, p 218
Harbert GM Jr, Cornell GW, Littlefield JB, et al: Maternal hemodynam- ics associated with uterine contraction in gravid monkeys. Am J Obstet Gynecol 104:24, 1969
Harstad TW, Mason RA, Cox SM: Serum erythropoietin quantitation in preg- nancy using an enzyme-linked immunoassay. Am J Perinatol 9:233, 1992 Hauguel-de Mouzon S, Lepercq J, Catalano P: The known and unknown of
leptin in pregnancy. Am J Obstet Gynecol 194:1537, 2006
Hayashi M, Inoue T, Hoshimoto K, et al: The levels of five markers of hemo- stasis and endothelial status at different stages of normotensive pregnancy.
Acta Obstet Gynecol Scand 81:208, 2002
Heenan AP, Wolfe LA, Davies GAL, et al: Effects of human pregnancy on fluid regulation responses to short-term exercise. J Appl Physiol 95:2321, 2003 Hegewald MJ, Crapo RO: Respiratory physiology in pregnancy. Clin Chest
Med 32(1):1, 2011
Hein M, Petersen Ac, Helmig RB, et al: Immunoglobulin levels and phago- cytes in the cervical mucus plug at term of pregnancy. Acta Obstet Gynecol Scand 84:734, 2005
Helal I, Fick-Brosnahan GM, Reed-Gitomer B, et al: Glomerular hyperfiltra- tion: definitions, mechanisms and clinical implications. Nat Rev Nephrol 8(5):293, 2012
Henry JF, Sherwin BB: Hormones and cognitive functioning during late preg- nancy and postpartum: a longitudinal study. Behav Neurosci 126(1):73, 2012 Henson MC, Castracane VD: Leptin in pregnancy: an update. Biol Reprod
74:218, 2006
Hibbard JU, Shroff SG, Cunningham FG: Cardiovascular alterations in normal and preeclamptic pregnancies. In Taylor RN, Roberts JM, Cunningham FG (eds): Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press, 2014
Higby K, Suiter CR, Phelps JY, et al: Normal values of urinary albumin and total protein excretion during pregnancy. Am J Obstet Gynecol 171:984, 1994 Hill JA, Olson EN: Cardiac plasticity. N Engl J Med 358:1370, 2008 Hladunewich MA, Lafayette RA, Derby GC, et al: The dynamics of glomerular
filtration in the puerperium. Am J Physiol Renal Physiol 286(3):F496, 2004 Hladunewich MA, Schaefer F: Proteinuria in special populations: pregnant
women and children. Adv Chronic Kidney Dis 18(4):267, 2011
Hodgkinson CP: Physiology of the ovarian veins in pregnancy. Obstet Gynecol 1:26, 1953
Holmes VA, Wallace JM: Haemostasis in normal pregnancy: a balancing act?
Biochem Soc Transact 33:428, 2005
Huerta-Enochian GS, Katz VL, Fox LK, et al: Magnetic resonance—based serial pelvimetry: do maternal pelvic dimensions change during pregnancy?
Am J Obstet Gynecol 194:1689, 2006
Hui C, Lili M, Libin C, et al: Changes in coagulation and hemodynamics dur- ing pregnancy: a prospective longitudinal study of 58 cases. Arch Gynecol Obstet 285(5):1231, 2012
Huisman A, Aarnoudse JG, Heuvelmans JHA, et al: Whole blood viscosity during normal pregnancy. Br J Obstet Gynaecol 94:1143, 1987
Hytten FE: Lactation. In The Clinical Physiology of the Puerperium. London, Farrand Press, 1995, p 59
Hytten FE: The renal excretion of nutrients in pregnancy. Postgrad Med J 49:625, 1973
Hytten FE: Weight gain in pregnancy. In Hytten FE, Chamberlain G (eds):
Clinical Physiology in Obstetrics, 2nd ed. Oxford, Blackwell, 1991, p 173 Hytten FE, Leitch I: The Physiology of Human Pregnancy, 2nd ed.
Philadelphia, Davis, 1971
Ingerslev M, Teilum G: Biopsy studies on the liver in pregnancy, 2. Liver biopsy on normal pregnant women. Acta Obstet Gynecol Scand 25:352, 1946
Inoue T, Hotta A, Awai M, et al: Loss of vision due to a physiologic pituitary enlargement during normal pregnancy. Graefe’s Arch Clin Exp Ophthalmol 245:1049, 2007
Iosif S, Ingemarsson I, Ulmsten U: Urodynamic studies in normal pregnancy and in puerperium. Am J Obstet Gynecol 137:696, 1980
Jain N, Sternberg LB: Symphyseal separation. Obstet Gynecol 105:1229, 2005 Jarolim P: Serum biomarkers for heart failure. Cardiovasc Pathol 15:144, 2006 Jauniaux E, Johnson MR, Jurkovic D, et al: The role of relaxin in the develop- ment of the uteroplacental circulation in early pregnancy. Obstet Gynecol 84:338, 1994
Jeffreys RM, Stepanchak W, Lopez B, et al: Uterine blood flow during supine rest and exercise after 28 weeks of gestation. BJOG 113:1239, 2006 Jensen D, Wolfe LA, Slatkovska L, et al: Effects of human pregnancy on the
ventilatory chemoreflex response to carbon dioxide. Am J Physiol Regul Integr Comp Physiol 288:R1369, 2005
Jensen E, Wood C, Keller-Wood M: The normal increase in adrenal secre- tion during pregnancy contributes to maternal volume expansion and fetal homeostasis. J Soc Gynecol Investig 9:362, 2002
Jonsson Y, Ruber M, Matthiesen L, et al: Cytokine mapping of sera from women with preeclampsia and normal pregnancies. J Reprod Immunol 70:83, 2006 Jung C, Ho JT, Torpy DJ, et al: A longitudinal study of plasma and urinary corti- sol in pregnancy and postpartum. J Clin Endocrinol Metab 96(5):1533, 2011 Kalhan SC, Gruca LL, Parimi PS, et al: Serine metabolism in human preg-
nancy. Am J Physiol Endocrinol Metab 284:E733, 2003
Kametas N, McAuliffe F, Krampl E, et al: Maternal electrolyte and liver function changes during pregnancy at high altitude. Clin Chim Acta 328:21, 2003a Kametas NA, McAuliffe F, Krampl E, et al: Maternal cardiac function in twin
pregnancy. Obstet Gynecol 102:806, 2003b
Kaneshige E: Serum ferritin as an assessment of iron stores and other hemato- logic parameters during pregnancy. Obstet Gynecol 57:238, 1981 Kaňová N, Bičiková M: Hyperandrogenic states in pregnancy. Physiol Res
60(2):243, 2011
Karakosta P, Chatzi L, Plana E, et al: Leptin levels in cord blood and anthro- pometric measures at birth: a systematic review and meta-analysis. Paediatr Perinat Epidemiol 25(2):150, 2010
Kauppila A, Chatelain P, Kirkinen P, et al: Isolated prolactin deficiency in a woman with puerperal alactogenesis. J Clin Endocrinol Metab 64:309, 1987 Kauppila A, Koskinen M, Puolakka J, et al: Decreased intervillous and unchanged myometrial blood flow in supine recumbency. Obstet Gynecol 55:203, 1980
Keenan PA, Yaldoo DT, Stress ME, et al: Explicit memory in pregnant women.
Am J Obstet Gynecol 179:731, 1998
Keller-Wood M, Wood CE: Pregnancy alters cortisol feedback inhibition of stimulated ACTH: studies in adrenalectomized ewes. Am J Physiol Regul Integr Comp Physiol 280:R1790, 2001
Kennedy RL, Malabu UH, Jarrod G, et al: Thyroid function and pregnancy:
before, during and beyond. J Obstet Gynaecol 30(8):774, 2010
Kenny L, McCrae K, Cunningham FG: Platelets, coagulation, and the liver.
In Taylor RN, Roberts JM, Cunningham FG (eds): Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press, 2014 Kinsella SM, Lohmann G: Supine hypotensive syndrome. Obstet Gynecol
83:774, 1994
Klafen A, Palugyay J: Vergleichende Untersuchungen über Lage und Ausdehrung von Herz und Lunge in der Schwangerschaft und im Wochenbett. Arch Gynaekol 131:347, 1927
Kletzky OA, Rossman F, Bertolli SI, et al: Dynamics of human chorionic gonadotropin, prolactin, and growth hormone in serum and amniotic fluid throughout normal human pregnancy. Am J Obstet Gynecol 151:878, 1985 Kolarzyk E, Szot WM, Lyszczarz J: Lung function and breathing regulation
parameters during pregnancy. Arch Gynecol Obstet 272:53, 2005 Kovacs CS, Fuleihan GE: Calcium and bone disorders during pregnancy and
lactation. Endocrin Metab Clin North Am 35:21, 2006
Krause BJ, Hanson MA, Casanello P: Role of nitric oxide in placental vascular development and function. Placenta 32(11):797, 2011
Krause PJ, Ingardia CJ, Pontius LT, et al: Host defense during pregnancy:
neutrophil chemotaxis and adherence. Am J Obstet Gynecol 157:274, 1987 Kubota T, Kamada S, Hirata Y, et al: Synthesis and release of endothelin-1 by
human decidual cells. J Clin Endocrinol Metab 75:1230, 1992
Kulandavelu S, Whiteley KJ, Bainbridge SA, et al: Endothelial NO synthase augments fetoplacental blood flow, placental vascularization, and fetal growth in mice. Hypertension 61(1):259, 2013
Kumru S, Boztosun A, Godekmerdan A: Pregnancy-associated changes in peripheral blood lymphocyte subpopulations and serum cytokine concen- trations in healthy women. J Reprod Med 50:246, 2005
Lammert F, Marschall HU, Glantz A, et al: Intrahepatic cholestasis of preg- nancy: molecular pathogenesis, diagnosis and management. J Hepatol 33:
1012, 2000