A longitudinal study of antenatal changes in lung function tests and importance of postpartum exercises in their recovery.

A study of changes in lung function tests during pregnancy was undertaken in fifty pregnant women beginning from third month of gestation. Fifty nonpregnant age and height matched women formed the controls. Forced Vital Capacity (FVC), Timed Vital Capacity (FEV1), Inspiratory Capacity (IC), Expiratory Reserve Volume (ERV) and peak Expiratory Flow Rate (PEFR) were performed in each month of pregnancy. However ten subjects were not available for follow-up during postpartum period. Remaining forty women were divided into two groups of twenty each. Group I performed daily graded active exercises to strengthen the anterior abdominal wall muscles. Group II women did not perform any exercises. It was observed that the antenatal changes in percent FVC and FEV1 were insignificant, but the decline in ERV and PEFR were very highly significant (P < 0.001) and the increment in IC was significant (P < 0.05). In the postpartum period the percentage variation of values in group I was less than 5% from controls (P > 0.05) and in group II it was 15-20% from controls (P < 0.05), resulting in a significant variation in group II women as compared to the controls. It is concluded that there are adaptive changes in lung functions in the antenatal period. We stress the importance of regular graded active exercises in the postpartum period for the speedy recovery of these changes.

A study of dyslipidemia and platelet adhesiveness in non-insulin dependent diabetes mellitus.

The present study included 50 controls (age 34-64 years) and 50 NIDDM subjects (age 32-72 years) from the diabetic clinic of Government Medical College, Nagpur. It was undertaken with the aim of investigating obesity indices (i.e. body mass index, skin fold thickness, waist hip ratio and % fat in the body); lipid profile (including serum total cholesterol, triglyceride, VLDL, LDL and HDL-cholesterol) levels and platelet adhesiveness in both the groups. On comparison, plasma glucose levels were higher in NIDDM (P > 0.05); obesity indices, cholesterol, triglyceride, VLDL, LDL and platelet adhesiveness index were higher, and HDL levels low in NIDDM group as compared to controls (P < 0.01). Obesity, dyslipidemia and increased platelet adhesiveness are interconnected and make diabetics more susceptible to arterial disease with increased risk of vascular episodes.

Effect of exercise on acid-base status and ventilatory kinetics.

The normal respiratory responses and changes in acid base status in twenty normal height, weight and age matched subjects were studied; using Auto Spiro AS 300 spirometer for ventilatory parameters and NOVA stat profile 3 analyser for gas analysis. Each subject performed a progressive incremental treadmill exercise by Bruce protocol to their symptom limited maximum. Minute ventilation (VE), tidal volume (VT) and frequency of respiration (f) increased significantly (P<0.001). Acidosis occured following exercise as pH of arterialized venous blood declined significantly (P<0.05). Gas analysis of arterialized venous blood showed a rise in pO2 (P<0.001) and a fall in pCO2 (P<0.001). Recovery of acid base status as well as gaseous pressure in blood did not occur after 10 min. Expired gas pCO2 declined significantly (P<0.05) and pO2 increase significantly (P<0.05). These pressures returned to resting levels 10 min after exercise. Thus in normal young adults heavy exercise caused an increment in ventilatory kinetics producing hyperpnoea which recovers after a rest of 10 min. Acidosis stimulates the respiratory centre to cause hyperventilation which tries to meet the added metabolic demands of strenuous exercise.

PEFR in pregnancy: a longitudinal study.

Peak expiratory flow rates (PEFR) were measured in 60 pregnant women aged 20-28 years (average 24 yrs) height between 130-160 cm (average 154.5 cm), each month beginning from 3rd month of gestation and also 8-10 weeks postpartum using, Wright's Peak Flow Meter. The PEFR declined from 329.12 +/- 4.40 lpm in 3rd month to 286.22 +/- 3.81 lpm in 9th month of gestation and increased to 347.86 +/- 2.93 lpm in postpartal period. A similar, declining trend is also observed in other Indian studies. However, the values are lower than those observed in Europeans. Also no change in PEFR during pregnancy was observed in an European study. The PEFR in our study regressed at a rate of 6.68 lpm/month of gestation and 5.49 lpm/kg increase in weight throughout pregnancy. The correlation with forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) is non-significant throughout pregnancy. The anaemic pregnant women showed lower PEFR when compared with PEFR of nonanaemic pregnant women, but showed a similar declining trend throughout pregnancy.

A longitudinal study of pulmonary function tests during pregnancy.

The study deals with evaluation of pulmonary function status in fifty normal pregnant women tested monthly. The parameters studied were Vital Capacity (VC) Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1st second (FEV1) using Vitalograph Spirometer; tidal volume (VT), inspiratory capacity (IC) and expiratory reserve volume (ERV) using Expirograph and resting minute ventilation (VE) using Tissot's spirometer. Control values were obtained in the same subject 8-10 weeks after delivery. The increase seen in VT, VE and IC was very highly significant. The small increment in frequency of respiration is significant and the declining trend observed in ERV is very highly significant. VC and FVC were maintained by the rise in IC and a concomitant fall in ERV. Rise in VC is attributed mainly to rise in VT than rise in frequency. The results suggest that though pulmonary function is altered during pregnancy, it is not compromised and hence does not induce any mechanical stress on the respiratory efficiency of the pregnant woman.

Serum level of iron and transferrin in pregnancy and postpartum period.

This study presents a composite picture of haemoglobin (Hb), serum level of iron (SI), total iron binding capacity (TIBC) and percent iron saturation of transferrin in women during different trimesters of pregnancy and postpartum period. The results were correlated with age and parity. A total of 75 subjects, 15 from each trimester and 15 postpartal, were studied and compared with 15 nonpregnant normal subjects. Signs of increased iron demand, increased iron turnover and obvious iron deficiency, were demonstrated throughout pregnancy, by decrease in haemoglobin, SI, percent iron saturation of transferrin and increased TIBC; especially in older age group and multigravidae. SI, TIBC and percent iron saturation of transferrin are more sensitive indices of iron status and provide us an opportunity to replenish iron stores of an iron deficient pregnant mother at an earlier date thus preventing anaemia.