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Dierickx I, Kremer C, Bruckers L, Ghossein-Doha C, Gyselaers W. Characteristics of the Maternal Jugular Venous Pulse Waveform by Combined Doppler-Electrocardiogram Assessment. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:895-900. [PMID: 35246340 DOI: 10.1016/j.ultrasmedbio.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
Standardized combined Doppler-electrocardiogram assessment was performed longitudinally at three different locations of internal jugular veins between 12 wk of gestation and 6 wk postnatally in 24 uncomplicated pregnancies. All images were classified as typical or non-typical based on the presence of the physiologic deflections A, X, H and C. Linear mixed models with random intercepts of typical images were used to investigate gestational changes in venous pulse transit time and venous impedance index. Unequivocal identification of venous pulse transit time and venous impedance index was possible in 2617 of 3798 (69%) and 2234 of 3798 (59%) images, respectively. The best identification rate (80%, 1018/1266) was at the right distal internal jugular vein. Venous pulse transit time increased with gestational age at all locations; venous impedance index decreased at the right sided internal jugular vein. Maternal jugular venous pulse waveform by combined Doppler-electrocardiogram allows unequivocal identification of A-deflection and calculation of venous pulse transit time and venous impedance index in around two-thirds of assessments, with the highest success rate at the right distal internal jugular vein. Gestational evolutions of venous pulse transit time and venous impedance index are similar to those reported at the level of renal interlobar and hepatic veins.
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Affiliation(s)
- Inge Dierickx
- Department of Obstetrics and Gynaecology, Sint Lucas Ziekenhuis, Gent, Belgium; Department of Physiology, Hasselt University, Hasselt, Belgium.
| | - Cécile Kremer
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| | - Liesbeth Bruckers
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Diepenbeek, Belgium
| | - Chahinda Ghossein-Doha
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wilfried Gyselaers
- Department of Physiology, Hasselt University, Hasselt, Belgium; Department of Obstetrics and Gynecology, Ziekenhuis Oost Limburg, Genk, Belgium
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Sima RM, Findeklee S, Bădărău IA, Poenaru MO, Scheau C, Pleș L. Comparison of maternal third trimester hemodynamics between singleton pregnancy and twin pregnancy. J Perinat Med 2021; 49:566-571. [PMID: 33567181 DOI: 10.1515/jpm-2020-0169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 01/04/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The impedance cardiography (ICG) technique measures the variation of impedance in the thorax due to the physical contractile activity of the heart. Twin pregnancy is characterized by greater maternal hemodynamic changes than a singleton pregnancy. METHODS In a study on 121 pregnant women in the last trimester we performed ICG, evaluating the following hemodynamic parameters: stroke volume, heart rate, cardiac output, ventricular ejection time, left ventricular ejection time, thoracic impedance, and systemic vascular resistance. RESULTS The study included singleton and twin pregnancies. Heart rate values in women with single fetus was lower than in those carrying twins (85 vs. 100 beats/min, p=0.021) as were the stroke volume values (64 vs. 83 mL, p=0.010) and the cardiac output (p<0.0001). Systemic vascular resistance decreased in twin pregnancies compared to singleton pregnancy (p=0.023). CONCLUSIONS ICG studies are rare, and the validation of their results is an ongoing process. However, the ICG technique is applicable in the third trimester of pregnancy and can yield important information regarding the hemodynamic profile of singleton and twin pregnancies, revealing maternal heart changes specific to twin pregnancies.
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Affiliation(s)
- Romina-Marina Sima
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,The "Bucur" Maternity, "Saint John" Hospital, Bucharest, Romania
| | - Sebastian Findeklee
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Hospital Homburg, Homburg, Germany.,Fertility Center Hamburg, Hamburg, Germany
| | - Ioana-Anca Bădărău
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mircea-Octavian Poenaru
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,The "Bucur" Maternity, "Saint John" Hospital, Bucharest, Romania
| | - Cristian Scheau
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Liana Pleș
- The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,The "Bucur" Maternity, "Saint John" Hospital, Bucharest, Romania
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Bellos I, Pergialiotis V. Doppler parameters of renal hemodynamics in women with preeclampsia: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2020; 22:1134-1144. [PMID: 32644302 DOI: 10.1111/jch.13940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022]
Abstract
The present meta-analysis aims to compare renal arterial and venous Doppler parameters in women with preeclampsia and healthy pregnant controls. Medline, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception to December 04, 2019. All observational studies reporting renal resistive index, pulsatility index, renal interlobar vein impedance, or pulse transit time among preeclamptic and healthy pregnant women were held eligible. Subgroup analysis was conducted on the basis of disease onset and side of measurement. Both pair-wise and network meta-analysis were performed using Review Manager 5.3 and R-3.4.3 software. Fourteen studies were included, with a total of 1118 women. No difference of renal resistive (MD: 0.00, 95% CI: [-0.03, 0.04]) and pulsatility index (MD: -0.01, 95% CI: [-0.14, 0.12]) was evident between the two groups. Renal interlobar vein impedance was estimated to be significantly higher in preeclampsia (MD: 0.07, 95% CI: [0.06, 0.09]), while venous pulse transit time was significantly lower (MD: -0.10, 95% CI: [-0.14, -0.05]) in women with the disease. Subgroup analysis indicated that early-onset preeclampsia was associated with significantly elevated renal interlobar vein impedance and lower venous pulse transit time than late-onset disease. The outcomes of the present meta-analysis suggest that preeclampsia is characterized by venous hemodynamic dysfunction as it is associated with significantly elevated renal interlobar vein impedance and shorter venous pulse transit time. Future large-scale prospective studies should introduce cutoff values and determine the optimal timing of measurement in order to achieve optimal predictive accuracy.
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Affiliation(s)
- Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Gyselaers W, Staelens A, Mesens T, Tomsin K, Oben J, Vonck S, Verresen L, Molenberghs G. Maternal venous Doppler characteristics are abnormal in pre-eclampsia but not in gestational hypertension. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 45:421-426. [PMID: 24890401 DOI: 10.1002/uog.13427] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/11/2014] [Accepted: 05/23/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To compare functional characteristics of maternal thoraco-abdominal arteries and veins in proteinuric and non-proteinuric hypertension in pregnancy. METHODS This retrospective study included women with singleton pregnancies during the third trimester, which were either uncomplicated or complicated with different clinical types of hypertension: non-proteinuric gestational hypertension (GH), early-onset pre-eclampsia (PE) diagnosed < 34 weeks or late-onset PE diagnosed ≥ 34 weeks. Demographic maternal and neonatal data were recorded, together with maternal serum and urine analytes. All women underwent standardized automated blood-pressure measurement, together with non-invasive impedance cardiography (ICG), for measurement of cardiac output (CO), aortic flow velocity index (VI) and aortic flow acceleration index (ACI). A standardized combined Doppler-electrocardiography assessment of maternal venous hemodynamics was performed to measure renal interlobar vein impedance index (RIVI), hepatic vein impedance index (HVI) and venous pulse transit time (VPTT) in liver and kidneys. Finally, resistance index (RI), pulsatility index (PI) and arterial pulse transit time (APTT) were measured in the uterine arcuate arteries. Mann-Whitney U-tests and Fisher's exact tests were used for intergroup comparisons, and linear dependence between variables was assessed using Pearson's correlation coefficient (r). RESULTS A total of 150 pregnancies were evaluated: 22 with uncomplicated pregnancy, 41 GH, 31 early PE and 56 late PE. Aortic VI and ACI were lower in GH, early PE and late PE than in uncomplicated pregnancy. Both early PE and late PE differed from GH by having shorter APTT in the uterine arcuate arteries and higher RIVI. Hemodynamic abnormalities were most pronounced in early PE, during which uterine arcuate artery RI was higher and VPTT in kidneys was shorter than in late PE. There was a significant correlation between degree of proteinuria and RIVI for the left (r = 0.381) and right (r = 0.347) kidney in late PE, but this was not true for early PE. CONCLUSIONS There is a gradient of worsening arterial and venous hemodynamic abnormalities from GH to late PE and then to early PE. Venous hemodynamic abnormalities are present only in PE, with a linear correlation between proteinuria and RIVI in late PE. The role of the maternal venous compartment in the pathophysiology and etiology of PE-related symptoms may be much more important than considered at present.
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Affiliation(s)
- W Gyselaers
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium; Department of Physiology, Hasselt University, Hasselt, Belgium
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Vonck S, Staelens AS, Mesens T, Tomsin K, Gyselaers W. Hepatic hemodynamics and fetal growth: a relationship of interest for further research. PLoS One 2014; 9:e115594. [PMID: 25536071 PMCID: PMC4275281 DOI: 10.1371/journal.pone.0115594] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/28/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It is well known that hepatic hemodynamics is an important physiologic mechanism in the regulation of cardiac output (CO). It has been reported that maternal cardiac output relates to neonatal weight at birth. AIMS In this study, we assessed the correlation between maternal hepatic vein Doppler flow parameters, cardiac output and neonatal birth weight. METHODS Healthy women with uncomplicated second or third trimester pregnancy attending the outpatient antenatal clinic of Ziekenhuis Oost-Limburg in Genk (Belgium), had a standardized combined electrocardiogram-Doppler ultrasound with Impedance Cardiography, for measurement of Hepatic Vein Impedance Index (HVI = [maximum velocity - minimum velocity]/maximum velocity), venous pulse transit time (VPTT = time interval between corresponding ECG and Doppler wave characteristics) and cardiac output (heart rate x stroke volume). After delivery, a population-specific birth weight chart, established from a cohort of 27000 neonates born in the index hospital, was used to define customized birth weight percentiles (BW%). Correlations between HVI, VPTT, CO and BW% were calculated using Spearman's ρ, linear regression analysis and R2 goodness of fit in SPSS 22.0. RESULTS A total of 73 women were included. There was a negative correlation between HVI and VPTT (ρ = -0.719, p < 0.001). Both HVI and VPTT correlated with CO (ρ = -0.403, p < 0.001 and ρ = 0.332, p < 0.004 resp.) and with BW% (ρ = -0.341, p < 0.003 and ρ = 0.296, p < 0.011 resp.). CONCLUSION Our data illustrate that the known contribution of hepatic hemodynamics in the regulation of cardiac output is also true for women with uncomplicated pregnancies. Our study is the first to illustrate a potential link between maternal hepatic hemodynamics and neonatal birth weight. Whether this link is purely associative or whether hepatic vascular physiology has a direct impact on fetal growth is to be evaluated in more extensive clinical and experimental research.
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Affiliation(s)
- Sharona Vonck
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- * E-mail:
| | - Anneleen Simone Staelens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Tinne Mesens
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Kathleen Tomsin
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Wilfried Gyselaers
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Department Physiology, Hasselt University, Hasselt, Belgium
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Mesens T, Tomsin K, Staelens AS, Oben J, Molenberghs G, Gyselaers W. Is there a correlation between maternal venous hemodynamic dysfunction and proteinuria of preeclampsia? Eur J Obstet Gynecol Reprod Biol 2014; 181:246-50. [PMID: 25190298 DOI: 10.1016/j.ejogrb.2014.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 07/24/2014] [Accepted: 08/07/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate in early and late preeclampsia a correlation of maternal venous Doppler flow characteristics with biochemical parameters in maternal serum and urine, or with gestational outcome. STUDY DESIGN In this observational cross-sectional study, renal interlobar vein impedance index (RIVI) was measured according to a standardised protocol for combined electrocardiogram-Doppler ultrasonography in 86 women with uncomplicated pregnancy, 78 women with late onset preeclampsia (≥34w) and 67 with early onset preeclampsia (<34w). For each group, maternal age, pre-gestational BMI and parity were recorded together with birth weight and -percentile. For both early onset and late onset preeclampsia, maternal serum was analysed for thrombocyte count and concentrations of creatinine, ASAT, ALAT and uric acid and 24h urine collections were analysed for creatinine clearance and proteinuria (mg/24h). A non-parametric Mann-Whitney U-tests was performed for continuous data and a Fisher's exact tests for categorical data. Significant linear dependence between variables was identified using Pearson's correlation coefficient at nominal level a=0.05. RESULTS Proteinuria was higher in early onset than in late onset preeclampsia (1756mg [838-6116mg] versus 877mg [416-1696mg], p<0.001), and this was also true for RIVI in both left (0.45 [0.40-0.55] versus 0.41 [0.35-0.45], p=0.001) and right kidney (0.45 [0.39-0.55] versus 0.38 [0.30-0.43], p<0.001). In our data set, there was a significant correlation between proteinuria and RIVI of left (correlation coefficient=0.172, p=0.036) and right kidney (correlation coefficient=0.218, p=0.009) in late onset but not early onset preeclampsia. CONCLUSION Maternal RIVI may correlate with proteinuria of late onset preeclampsia.
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Affiliation(s)
- Tinne Mesens
- Dept. Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
| | - Kathleen Tomsin
- Dept. Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Jolien Oben
- Dept. Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
| | | | - Wilfried Gyselaers
- Dept. Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium; Dept. of Physiology, Hasselt University, Hasselt, Belgium
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Staelens ASE, Tomsin K, Oben J, Mesens T, Grieten L, Gyselaers W. Improving the reliability of venous Doppler flow measurements: relevance of combined ECG, training and repeated measures. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1722-1728. [PMID: 24631376 DOI: 10.1016/j.ultrasmedbio.2014.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/28/2013] [Accepted: 01/13/2014] [Indexed: 06/03/2023]
Abstract
The nature of venous Doppler waves is highly variable. An additional electrocardiogram (ECG) improves the interpretation of venous Doppler wave characteristics and allows measurement of venous pulse transit time. The purpose of this study was to assess the reproducibility of ECG-guided repeated measurements of venous Doppler flow characteristics before and after sonographer training and the inter- and intra-observer variability. In four groups of 25 healthy women, venous Doppler flow measurements were performed at the level of the kidneys and liver according to a standardized protocol. Intra-observer Pearson correlation coefficients of the renal interlobar vein Doppler indices were ≥ 0.80 with the addition of the ECG, which are higher than the results of a former study. The inter-observer correlation between an experienced ultrasonographer and an inexperienced ultrasonographer improved from ≥ 0.71 to ≥ 0.91 after training. The correlation range of all parameters between two independent observers improved when values were based on repeated measures. The addition of an ECG to the Doppler image, training and repeated measurements are helpful in improving venous Doppler wave interpretation.
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Affiliation(s)
- Anneleen S E Staelens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
| | - Kathleen Tomsin
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Jolien Oben
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Tinne Mesens
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Lars Grieten
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Wilfried Gyselaers
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium
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Gyselaers W, Tomsin K, Staelens A, Mesens T, Oben J, Molenberghs G. Maternal venous hemodynamics in gestational hypertension and preeclampsia. BMC Pregnancy Childbirth 2014; 14:212. [PMID: 24957330 PMCID: PMC4090345 DOI: 10.1186/1471-2393-14-212] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 06/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate characteristics of venous hemodynamics, together with cardiac and arterial function, in uncomplicated pregnancies (UP), non-proteinuric gestational hypertension (GH) and preeclampsia (PE). Methods In this observational cross-sectional study, venous hemodynamics was assessed using a standardised protocol for combined electrocardiogram (ECG)-Doppler ultrasonography, together with a non-invasive standardised cardiovascular assessment using impedance cardiography (ICG) in 13 women with UP, 21 with GH, 34 with late onset PE ≥ 34 w (LPE) and 22 with early onset PE < 34 w (EPE). ECG-Doppler parameters were impedance index at the level of hepatic veins (HVI) and renal interlobar veins (RIVI) together with venous pulse transit times (VPTT), as well as resistive and pulsatility index, and arterial pulse transit time (APTT) at the level of uterine arcuate arteries. ICG parameters were aortic flow velocity index (VI), acceleration index (ACI) and thoracic fluid content. Mann Whitney U-test, Kruskall-Wallis test and linear regression analysis with heteroskedastic variance was used for statistical analysis. Results RIVI in both kidneys was >15% higher (P ≤ .010) in LPE and EPE, as compared to GH and UP. Next to this, >30% lower values for VI and ACI (P ≤ .029), and > 15% lower values for APTT (P ≤ .012) were found in GH, LPE and EPE, as compared to GH. Conclusion In comparison to UP, similar abnormalities of central arterial function and APTT were found in GH, EPE and LPE. Proteinuria of LPE and EPE was associated with increased RIVI, this was not observed in GH.
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Affiliation(s)
- Wilfried Gyselaers
- Department of Obstetrics & Gynaecology, Ziekenhuis Oost, Limburg Schiepse Bos 6, 3600 Genk, Belgium.
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Mesens T, Tomsin K, Oben J, Staelens A, Gyselaers W. Maternal venous hemodynamics assessment for prediction of preeclampsia should be longitudinal. J Matern Fetal Neonatal Med 2014; 28:311-5. [PMID: 24846698 DOI: 10.3109/14767058.2014.916673] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To address the question whether maternal venous abnormalities exist at the onset of, or develop during the course of pregnancy. METHODS We present five case reports of patients with early onset preeclampsia (EPE), late onset preeclampsia (LPE), gestational hypertension (GH), essential hypertension (EH) and an uncomplicated pregnancy (UP). Maternal renal and hepatic vein Doppler waves and maternal venous pulse transit times (VPTT) were assessed in early pregnancy and again shortly before delivery. RESULTS In all cases, maternal VPTT were normal in early pregnancy and changed to abnormal values in EPE and LPE, which was not true for UP and GH or EH. CONCLUSION These observations support the view that venous hemodynamic dysfunction of preeclampsia (PE) develops during the course of pregnancy. Therefore, assessment of an individual's venous function for prediction of PE should be serial and longitudinal.
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Affiliation(s)
- Tinne Mesens
- Department of Obstetrics and Gynaecology , Ziekenhuis Oost-Limburg, Genk , Belgium
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Oben J, Tomsin K, Mesens T, Staelens A, Molenberghs G, Gyselaers W. Maternal cardiovascular profiling in the first trimester of pregnancies complicated with gestation-induced hypertension or fetal growth retardation: a pilot study. J Matern Fetal Neonatal Med 2014; 27:1646-51. [DOI: 10.3109/14767058.2013.871700] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tomsin K, Vriens A, Mesens T, Gyselaers W. Non-invasive cardiovascular profiling using combined electrocardiogram-Doppler ultrasonography and impedance cardiography: An experimental approach. Clin Exp Pharmacol Physiol 2013; 40:438-42. [DOI: 10.1111/1440-1681.12105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 04/27/2013] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Annette Vriens
- Faculty of Medicine and Life Sciences; Hasselt University; Diepenbeek; Belgium
| | - Tinne Mesens
- Department of Obstetrics and Gynaecology; Ziekenhuis Oost-Limburg; Genk; Belgium
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Tomsin K, Mesens T, Molenberghs G, Gyselaers W. Venous Pulse Transit Time in Normal Pregnancy and Preeclampsia. Reprod Sci 2012; 19:431-6. [DOI: 10.1177/1933719111424440] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kathleen Tomsin
- Department. Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Department. Physiology, Hasselt University, Diepenbeek, Belgium
| | - Tinne Mesens
- Department. Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Geert Molenberghs
- I-BioStat, Hasselt University, Diepenbeek, Belgium
- I-BioStat, Catholic University of Leuven, Leuven, Belgium
| | - Wilfried Gyselaers
- Department. Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Department. Physiology, Hasselt University, Diepenbeek, Belgium
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Gyselaers W, Mullens W, Tomsin K, Mesens T, Peeters L. Role of dysfunctional maternal venous hemodynamics in the pathophysiology of pre-eclampsia: a review. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 38:123-129. [PMID: 21611996 DOI: 10.1002/uog.9061] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The venous compartment has an important function in regulation and control of cardiac output. Abnormalities of cardiac output have been found in early gestational stages of both early- and late-onset pre-eclampsia. The venous compartment also maintains the balance between circulating and non-circulating blood volumes and regulates the amount of reserve blood stored in the splanchnic venous bed. It is well known that adaptive regulation of maternal blood volume is disturbed in pre-eclampsia. Abnormal venous hemodynamics and venous congestion are responsible for secondary dysfunction of several organs, such as the kidneys in cardiorenal syndrome and the liver in cardiac cirrhosis. Renal and liver dysfunctions are among the most relevant clinical features of pre-eclampsia. Doppler sonography studies have shown that the maternal venous compartment is subject to gestational adaptation, and that blood flow characteristics at the level of renal interlobar and hepatic veins are different in pre-eclampsia compared with uncomplicated pregnancy. In comparison to late-onset pre-eclampsia, in early-onset pre-eclampsia venous Doppler flow abnormalities are more prominent and present up to weeks before clinical symptoms. This paper reviews the growing evidence that dysfunction of maternal venous hemodynamics is part of the pathophysiology of pre-eclampsia and may perhaps be more important than is currently considered. Doppler sonography is a safe and easily performed method with which to study maternal venous hemodynamics. Therefore, exploring the role of maternal venous hemodynamics using Doppler sonography is an exciting new research topic for those who are interested in cardiovascular background mechanisms, as well as prediction and clinical work-up of pre-eclampsia.
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Affiliation(s)
- W Gyselaers
- Department of Obstetrics and Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
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