At what gestational age maximum rise of cardiac output is reached

Cardiac output in Pregnancy It is increased as early as the fifth week, reaches its peak 40-50% at about 30-34 weeks and remains elevated during the remainder of pregnancy It reflects a reduced systemic vascular resistance and an increased hea rate. CO is lowest in the sitting or supine position and highest in the right or left lateral or knee chest position. CO increases futher during labour (+50%) over the prelabor values Immediately following delivery (70%) over the prelabour values The resting pulse rate increases approximately 10 beats/min during pregnancy CO returns normal prelabour vaules by 1hr following delivery and to the pre pregnant values by another 4weeks time. During normal pregnancy Mean aerial pressure and vascular resistance decrease Blood volume and basal metabolic rate increase As a result, cardiac output at rest, when measured in the lateral recumbent position, increases significantly beginning in early pregnancy Reference: William's Obstetrics; 24th edition; Chapter 4 &DC.Duttas textbook of OBG, 9th edition,page 48