Chapter 55 - Autonomic Control During Pregnancy

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This chapter discusses how pregnancy activates the sympathetic nervous system and pregnancy impairs the baroreceptor reflex. In parallel to increases in fluid-retaining hormones, alterations in the autonomic nervous system accompany normal pregnancy. While pregnancy induces sympathoexcitation, simultaneously, basal parasympathetic tone decreases. Baroreflex dysfunction has been documented in several species besides humans, including rabbits, rats, goats, sheep, and dogs. While pregnancy could depress the function of any or all anatomical links within the baroreflex pathway, current evidence indicates that brain control is particularly impaired. Insulin resistance is a normal adaption of pregnancy that, by increasing circulating glucose levels, serves to enhance glucose availability into the fetus. Preeclampsia is a potentially fatal hypertensive disorder of pregnancy that is initiated by reduced placental perfusion. Increased sympathetic tone may contribute to the hypertension, since basal muscle sympathetic nerve activity is clearly increased above the levels observed in normal pregnant women. The changes in basal autonomic tone may counteract to some degree the profound vasodilation that is a hallmark of normal pregnancy.

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