Changes in Cardiac Output

A striking increase in cardiac output is seen within the first 6 weeks of pregnancy. Cardiac output in a typical 55-kg woman increases from about 4.8 L/min before fertilization to more than 7 L/min after the first trimester and remains elevated until delivery. The increase in cardiac output is accompanied by a modest decrease in mean blood pressure resulting primarily from a decline in diastolic pressure. This decrease in blood pressure is seen despite a 50% increase in blood volume and persists until about the middle of the second trimester when blood pressure gradually rises to about or perhaps slightly above the prepregnant level. The increase in cardiac output and the decrease in arterial blood pressure result from a pronounced decrease in total peripheral resistance (Fig. 3).

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