Maternal haemodynamics in normal pregnancies and in pregnancies affected by pre-eclampsia

5 years ago

Maternal haemodynamics in normal pregnancies and in pregnancies affected by pre-eclampsia

Daniel Stott, Kypros H. Nicolaides, Obianuju Nzelu, Nikos A. Kametas

Objectives To determine if in a high risk group in the first half of pregnancy, women who developed pre-eclampsia (PE) with fetal growth restriction (PE-FGR) demonstrate distinct haemodynamics compared to those with PE in the absence of FGR (PE-only). Methods Cardiac output (CO), peripheral vascular resistance (PVR) and mean arterial pressure (MAP) were measured at the first hospital visit at 9–24 weeks’ gestation in 69 women who had chronic hypertension and 67 who had a hypertensive disorder in a previous pregnancy. In total, 19 subsequently developed PE-only, 22 developed PE-FGR, 17 developed pregnancy induced hypertension and 78 had uncomplicated pregnancies and the haemodynamic values in each of these groups were compared to those of a cohort of 300 low-risk women with normal pregnancies. Results In all the high risk groups, compared to normal pregnancies, PVR and MAP were increased, but CO in the group of PE with FGR was reduced whereas in the other high risk groups it was not significantly different from normal. Conclusions In women that develop PE there is evidence of high PVR and MAP from the first half of pregnancy and those with PE and FGR demonstrate evidence of failure in the physiological expansion in CO.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.18835