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Liang H, Vårtun Å, Flo K, Widnes C, Acharya G. Maternal cardiac function, uterine artery hemodynamics and natriuretic peptides at 22-24 weeks of gestation and subsequent development of hypertensive disorders of pregnancy. Acta Obstet Gynecol Scand 2019; 98:507-514. [PMID: 30586148 DOI: 10.1111/aogs.13525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/16/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Maternal cardiac dysfunction as well as abnormal uterine artery (UtA) Doppler are associated with hypertensive disorders of pregnancy (HDP), but their relation is unclear. We investigated the correlation between maternal cardiac function, UtA hemodynamics and natriuretic peptides, and explored differences between women who subsequently developed HDP and those who did not. MATERIAL AND METHODS This was a prospective cross-sectional cohort study of 347 pregnant women at 22-24 weeks. Maternal cardiac function and systemic hemodynamics were investigated at baseline and after 90 seconds of passive leg raising using impedance cardiography. Preload reserve was defined as percent change (Δ%) in stroke volume and cardiac output from baseline to passive leg raising. UtA hemodynamics was studied using Doppler ultrasonography. UtA blood flow, resistance and pulsatility index were calculated. Fasting venous blood samples were analyzed for natriuretic peptides (pro atrial natriuretic peptide [proANP], N-terminal pro brain natriuretic peptide [Nt-proBNP] and C-type natriuretic peptide [CNP]). The course and outcome of pregnancy were recorded. RESULTS At baseline, ProANP correlated significantly with cardiac output (r = -0.122; P = .023) and left cardiac work index (r = -0.112; P = .037), whereas Nt-ProBNP correlated significantly with acceleration index (r = .127; P = .018) and velocity index (r = -0.111; P = .039. CNP correlated significantly with UtA blood flow (r = .118; P = .028) and resistance (r = -0.112; P = .037) but not with UtA pulsatility index (r = .034; P = .523). None of the natriuretic peptides correlated with preload reserve. At 22-24 weeks, women who subsequently developed HDP had lower UtA blood flow (552 vs 692 mL/min; P = .028), higher UtA resistance (0.28 vs .17 mmHg/mL/min; P = .004) and higher mean UtA pulsatility index (1.12 vs .84; P < .001) compared with those who did not; however, the natriuretic peptide levels were similar in the two groups. Women developing HDP had a significantly higher increase in stroke volume and cardiac output and more reduction in systemic vascular resistance following passive leg raising compared with the reference group. Left cardiac work index, acceleration index and velocity index decreased following passive leg raising in the reference group but increased in women who later developed HDP. CONCLUSIONS ProANP correlated with cardiac output and cardiac work, Nt-proBNP with indices of cardiac contractility, and CNP with UtA blood flow and resistance. None of these natriuretic peptides measured at 22-24 weeks of gestation reflected cardiac preload reserve or predicted development of HDP.
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Affiliation(s)
- Huan Liang
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Obstetrics, and Gynecology, Hospital of Fudan University, Shanghai, China
| | - Åse Vårtun
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway and University Hospital of North Norway, Tromsø, Norway
| | - Kari Flo
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway and University Hospital of North Norway, Tromsø, Norway
| | - Christian Widnes
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway and University Hospital of North Norway, Tromsø, Norway
| | - Ganesh Acharya
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway and University Hospital of North Norway, Tromsø, Norway.,Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden
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Agreement between preload reserve measured by impedance cardiography and echocardiography during pregnancy. Arch Gynecol Obstet 2018; 298:59-66. [PMID: 29623416 PMCID: PMC5995996 DOI: 10.1007/s00404-018-4773-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/03/2018] [Indexed: 11/17/2022]
Abstract
Purpose Accurate assessment of cardiac function is important during pregnancy. Echocardiography and impedance cardiography (ICG) are commonly used noninvasive methods to measure stroke volume (SV) and cardiac output (CO). The difference in stroke volume (ΔSV) or cardiac output (ΔCO) measured at baseline and after passive leg raising (PLR) is a measure of preload reserve that predicts volume responsiveness. However, the agreement between these two methods in measuring preload reserve during pregnancy is unclear. The aim of our study was to investigate the correlation and the agreement between Doppler echocardiography and ICG in assessing preload reserve in pregnant women. Methods In this prospective observational cross-sectional study, preload reserve was assessed by measuring the SV and CO during baseline and 90 s after PLR simultaneously by Doppler echocardiography and ICG in healthy pregnant women during the second and third trimesters. Bland–Altman analysis was used to determine the agreement between the two methods. Bias was calculated as the mean difference between two methods and precision as 1.96 SD of the difference. Results A total of 53 pregnant women were included. We found a statistically significant correlation between ΔSV (R = 0.56, p < 0.0001) and ΔCO (R = 0.39, p = 0.004) measured by ICG and Doppler echocardiography. The mean bias for ΔSV was 2.52 ml, with a precision of 18.19 ml. The mean bias for ΔCO was 0.21 l/min, with a precision of 1.51 l/min. Conclusion There was a good agreement and a statistically significant correlation between ICG and Doppler echocardiography for measuring preload reserve.
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Vårtun Å, Flo K, Widnes C, Acharya G. Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22-24 Weeks of Gestation. PLoS One 2016; 11:e0157916. [PMID: 27308858 PMCID: PMC4911143 DOI: 10.1371/journal.pone.0157916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
Objective To compare cardiac function, systemic hemodynamics and preload reserve of women with increased (cases) and normal (controls) uterine artery (UtA) pulsatility index (PI) at 22–24 weeks of gestation. Materials and Methods A prospective cross-sectional study of 620 pregnant women. UtA blood flow velocities were measured using Doppler ultrasonography, and PI was calculated. Mean UtA PI ≥ 1.16 (90th percentile) was considered abnormal. Maternal hemodynamics was investigated at baseline and during passive leg raising (PLR) using impedance cardiography (ICG). Preload reserve was defined as percent increase in stroke volume (SV) 90 seconds after passive leg raising compared to baseline. Results Mean UtA PI was 1.49 among cases (n = 63) and 0.76 among controls (n = 557) (p < 0.0001). Eighteen (28.6%) cases and 53 (9.5%) controls developed pregnancy complications (p <0.0001). The mean arterial pressure and systemic vascular resistance were 83 mmHg and 1098.89±293.87 dyne s/cm5 among cases and 79 mmHg and 1023.95±213.83 dyne s/cm5 among controls (p = 0.007 and p = 0.012, respectively). Heart rate, SV and cardiac output were not different between the groups. Both cases and controls responded with a small (4–5%) increase in SV in response to PLR, but the cardiac output remained unchanged. The preload reserve was not significantly different between two groups. Conclusion Pregnant women with abnormal UtA PI had higher blood pressure and systemic vascular resistance, but similar functional hemodynamic profile at 22–24 weeks compared to controls. Further studies are needed to clarify whether functional hemodynamic assessment using ICG can be useful in predicting pregnancy complications.
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Affiliation(s)
- Åse Vårtun
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
- * E-mail:
| | - Kari Flo
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
| | - Christian Widnes
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
| | - Ganesh Acharya
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Andreas M, Kuessel L, Kastl SP, Wirth S, Gruber K, Rhomberg F, Gomari-Grisar FA, Franz M, Zeisler H, Gottsauner-Wolf M. Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome. BMC Pregnancy Childbirth 2016; 16:128. [PMID: 27251149 PMCID: PMC4888315 DOI: 10.1186/s12884-016-0918-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 05/25/2016] [Indexed: 12/22/2022] Open
Abstract
Background Pregnancy associated cardiovascular pathologies have a significant impact on outcome for mother and child. Bioimpedance cardiography may provide additional outcome-relevant information early in pregnancy and may also be used as a predictive instrument for pregnancy-associated diseases. Methods We performed a prospective longitudinal cohort trial in an outpatient setting and included 242 pregnant women. Cardiac output and concomitant hemodynamic data were recorded from 11th–13th week of gestation every 5th week as well as at two occasions post partum employing bioimpedance cardiography. Results Cardiac output increased during pregnancy and peaked early in the third trimester. A higher heart rate and a decreased systemic vascular resistance were accountable for the observed changes. Women who had a pregnancy-associated disease during a previous pregnancy or developed hypertension or preeclampsia had a significantly increased cardiac output early in pregnancy. Furthermore, an effect of cardiac output on birthweight was found in healthy pregnancies and could be confirmed with multiple linear regression analysis. Conclusions Cardiovascular adaptation during pregnancy is characterized by distinct pattern described herein. These may be altered in women at risk for preeclampsia or reduced birthweigth. The assessment of cardiac parameters by bioimpedance cardiography could be performed at low costs without additional risks.
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Affiliation(s)
- Martin Andreas
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
| | - Lorenz Kuessel
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Stefan P Kastl
- Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria
| | - Stefan Wirth
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Kathrin Gruber
- Institute for Service Marketing and Tourism, University of Economics and Business, Vienna, Austria
| | - Franziska Rhomberg
- Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria
| | - Fatemeh A Gomari-Grisar
- Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria
| | - Maximilian Franz
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Harald Zeisler
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Michael Gottsauner-Wolf
- Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria
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Martin E, Anyikam A, Ballas J, Buono K, Mantell K, Huynh-Covey T, Archer T. A validation study of electrical cardiometry in pregnant patients using transthoracic echocardiography as the reference standard. J Clin Monit Comput 2015; 30:679-86. [DOI: 10.1007/s10877-015-9771-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
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Vårtun Å, Flo K, Wilsgaard T, Acharya G. Maternal functional hemodynamics in the second half of pregnancy: a longitudinal study. PLoS One 2015; 10:e0135300. [PMID: 26258418 PMCID: PMC4530890 DOI: 10.1371/journal.pone.0135300] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 07/20/2015] [Indexed: 01/04/2023] Open
Abstract
Objective Cardiovascular response to passive leg raising (PLR) is useful in assessing preload reserve, but it has not been studied longitudinally during pregnancy. We aimed to investigate gestational age associated serial changes in maternal functional hemodynamics and establish longitudinal reference ranges for the second half of pregnancy. Materials and Methods This was a prospective longitudinal study on 98 healthy pregnant women who were examined 3–5 times during 20–40 weeks of gestation (a total of 441 observations). Maternal cardiac function and systemic hemodynamics were assessed at baseline and 90 seconds after PLR using impedance cardiography (ICG). The main outcome measures were gestational age specific changes in ICG-derived variables of maternal cardiovascular function and functional hemodynamic response to PLR. Results Hemodynamic response to PLR varied during pregnancy. PLR led to an insignificant increase in stroke volume during 20+0 to 31+6 weeks, but later in gestation the stroke volume was slightly lower at PLR compared to baseline. PLR caused no significant change in cardiac output between 20+0 and 23+6 weeks and a significant decrease after 24+0 weeks. A decrease in heart rate, mean arterial pressure, and cardiac contractility was observed during PLR throughout the second half of pregnancy. Systemic vascular resistance was reduced by PLR up to 32+0 weeks, but increased slightly thereafter. Conclusion Healthy pregnant women appear to have limited preload reserve and reduced cardiac contractility, especially in the third trimester, which makes them vulnerable to fluid overload and cardiac failure.
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Affiliation(s)
- Åse Vårtun
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
- * E-mail:
| | - Kari Flo
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway, Tromsø, Norway
| | - Ganesh Acharya
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT- The Arctic University of Norway and Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Vårtun Å, Flo K, Acharya G. Effect of passive leg raising on systemic hemodynamics of pregnant women: a dynamic assessment of maternal cardiovascular function at 22-24 weeks of gestation. PLoS One 2014; 9:e94629. [PMID: 24732308 PMCID: PMC3986105 DOI: 10.1371/journal.pone.0094629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 03/19/2014] [Indexed: 12/22/2022] Open
Abstract
Objective To investigate functional hemodynamic response to passive leg raising in healthy pregnant women and compare it with non-pregnant controls. Materials and Methods This was a prospective cross-sectional study with a case-control design. A total of 108 healthy pregnant women at 22–24 weeks of gestation and 54 non-pregnant women were included. Cardiac function and systemic hemodynamics were studied at baseline and 90 seconds after passive leg raising using non-invasive impedance cardiography. Main outcome measures Trends and magnitudes of changes in impedance cardiography derived parameters of cardiac function and systemic hemodynamics caused by passive leg raising, and preload responsiveness defined as >10% increase in stroke volume or cardiac output after passive leg raising compared to baseline. Results The hemodynamic parameters in both pregnant and non-pregnant women changed significantly during passive leg raising compared to baseline, but the magnitude and trend of change was similar in both groups. The stroke volume increased both in pregnant (p = 0.042) and non-pregnant (p = 0.018) women, whereas the blood pressure and systemic vascular resistance decreased (p<0.001) following passive leg raising in both groups. Only 14.8% of pregnant women and 18.5% of non-pregnant women were preload responsive and the difference between groups was not significant (p = 0.705). Conclusion Static measures of cardiovascular status are different between healthy pregnant and non-pregnant women, but the physiological response to passive leg raising is similar and not modified by pregnancy at 22–24 weeks of gestation. Whether physiological response to passive leg raising is different in earlier and later stages of pregnancy merit further investigation.
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Affiliation(s)
- Åse Vårtun
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
- * E-mail:
| | - Kari Flo
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
| | - Ganesh Acharya
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø and Department of Obstetrics and Gynaecology University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Maternal Hemodynamics by Thoracic Impedance Cardiography for Normal Pregnancy and the Postpartum Period. Obstet Gynecol 2014; 123:318-324. [DOI: 10.1097/aog.0000000000000104] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Noninvasive cardiac monitoring in pregnancy: impedance cardiography versus echocardiography. J Perinatol 2013; 33:675-80. [PMID: 23680787 PMCID: PMC3751992 DOI: 10.1038/jp.2013.35] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 01/16/2013] [Accepted: 02/12/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to report thoracic impedance cardiography (ICG) measurements and compare them with echocardiography (echo) measurements throughout pregnancy and in varied maternal positions. METHOD A prospective cohort study involving 28 healthy parturients was performed using ICG and echo at three time points and in two maternal positions. Pearson's correlations, Bland-Altman plots and paired t-tests were used for statistical analysis. RESULT Significant agreements between many but not all ICG and echo contractility, flow and resistance measurements were demonstrated. Differences in stroke volume (SV) due to maternal position were also detected by ICG in the antepartum (AP) period. Significant trends were observed by ICG for cardiac output and thoracic fluid content (TFC; P<0.025) with advancing pregnancy stages. CONCLUSION ICG and echo demonstrate significant correlations in some but not all measurements of cardiac function. ICG has the ability to detect small changes in SV associated with maternal position change. ICG measurements reflected maximal cardiac contractility in the a AP period yet reflected a decrease in contractility and an increase in TFC in the postpartum period.
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San-Frutos L, Engels V, Zapardiel I, Perez-Medina T, Almagro-Martinez J, Fernandez R, Bajo-Arenas JM. Hemodynamic changes during pregnancy and postpartum: a prospective study using thoracic electrical bioimpedance. J Matern Fetal Neonatal Med 2011; 24:1333-40. [DOI: 10.3109/14767058.2011.556203] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Parrish MR, Laye MR, Wood T, Keiser SD, Owens MY, May WL, Martin JN. Impedance cardiography facilitates differentiation of severe and superimposed preeclampsia from other hypertensive disorders. Hypertens Pregnancy 2010; 31:327-40. [PMID: 20822427 DOI: 10.3109/10641955.2010.507850] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine if hemodynamic profiling using noninvasive impedance cardiography (ICG) reliably identifies the patient with severe (SPRE) or superimposed (SuPRE) preeclampsia. METHODS Late gestation hypertensive pregnant patients underwent immediate ICG evaluation. Findings were compared between patients subsequently achieving or not achieving American College of Obstetricians and Gynecologists criteria for SPRE or SuPRE. RESULTS Patients with severe disease were more likely to have depressed cardiac function and higher systolic blood pressure, mean arterial blood pressure, systemic vascular resistance, and thoracic fluid content compared to nonsevere hypertensive disease. CONCLUSION ICG hemodynamic profiling of late gestation hypertensive patients can rapidly and reliably identify those with SPRE or SuPRE.
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Affiliation(s)
- Marc R Parrish
- Department of Obstetrics and Gynecology, Winfred L. Wiser Hospital for Women and Infants, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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San-Frutos LM, Fernández R, Almagro J, Barbancho C, Salazar F, Pérez-Medina T, Bueno B, Bajo J. Measure of hemodynamic patterns by thoracic electrical bioimpedance in normal pregnancy and in preeclampsia. Eur J Obstet Gynecol Reprod Biol 2005; 121:149-53. [PMID: 16054954 DOI: 10.1016/j.ejogrb.2004.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2004] [Revised: 11/08/2004] [Accepted: 12/23/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the differences in the hemodynamics between normal pregnancy and preeclampsia, using thoracic electrical bioimpedance. STUDY DESIGN We compared heart rate, end-diastolic volume, systolic volume, cardiac output, ejection fraction and peripheral vascular resistances in 18 healthy pregnant women with 15 with preeclamptic women at the following intervals: third trimester, 48 h post-partum, 2 and 6 months post-partum. We took the measurements by thoracic electrical bioimpedance. Statistical analysis was performed by means of Wilcoxon rank-sum test and p < 0.05 was considered statistically significant. RESULTS The heart rate was lower in the preeclampsia group during the third trimester and the systolic volume was also lower at 48 h post-partum; this implies a lower cardiac output in women with preeclampsia during pregnancy and in the immediate puerperium. The systemic vascular resistances were higher in preeclampsia in the third trimester and at 48 h post-partum. At 2 and 6 months post-partum, the hemodynamic situation had equalized in both groups. CONCLUSIONS Preeclampsia is a situation of low cardiac output and high peripheral resistances compared with a normal pregnancy.
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Affiliation(s)
- Luis M San-Frutos
- Department of Obstetrics and Gynecology, Universitary Hospital Santa Cristina, Universidad Autónoma, C/ Maestro Vives, 2 228009 Madrid, Spain.
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