A longitudinal study of the relationship between maternal cardiac output measured by impedance cardiography and uterine artery blood flow in the second half of pregnancy

Flo, Kari; Wilsgaard, Tom; Vårtun, Åse; Acharya, Ganesh

doi:10.1111/j.1471-0528.2010.02548.x

Cited by 79 publications

(53 citation statements)

References 35 publications

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“…The demographic and clinical characteristics of women included in the longitudinal arm of the study have been reported previously. [3] Briefly, all the 53 participants were healthy women, and none of them developed any significant pregnancy complications. Follow up data on the course of pregnancy and perinatal outcome were available for all the participants.…”

Section: Resultsmentioning

confidence: 99%

“…Fifty-three healthy pregnant women were recruited to the longitudinal arm of the study [3]. Blood samples were obtained serially between 22 and 40 weeks of gestation at approximately 4-weekly intervals (a total of 243 samples).…”

Section: Methodsmentioning

confidence: 99%

“…Among a total of 641 pregnant women recruited to the cross-sectional arm of the study [3], 29 (4.5%) developed preeclampsia. Preeclampsia was defined as blood pressure (BP) of at least 140 mmHg (systolic) and/or 90 mmHg (diastolic) with proteinuria ≥1+ on dipstick, measured on at least two occasions 6 h apart after the 20th week of gestation.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal reference ranges for maternal plasma laeverin, and its role as a potential biomarker of preeclampsia

Nystad

Sitras

Flo

et al. 2016

BMC Pregnancy Childbirth

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BackgroundLaeverin is a placenta-specific membrane-bound aminopeptidase. In this study we wanted to: 1) serially measure plasma levels of laeverin in healthy women during the second half of pregnancy and postpartum, 2) determine whether laeverin is differently expressed at 22–24 weeks in women who later develop preeclampsia compared to controls, 3) compare laeverin protein expression in placenta and umbilical vein serum in healthy and preeclamptic pregnancies at birth.MethodsPlasma was obtained serially, approximately every 4-weeks, from 53 healthy women with uncomplicated pregnancies during 22+0 to 39+6 weeks of gestation, and at 22–24 weeks from 15 women who later developed preeclampsia. Enzyme-linked immunosorbent assay was used to measure laeverin protein concentration. Serum from healthy non-pregnant premenopausal women (n = 10), menopausal women (n = 10) and men (n = 11) were used as negative controls. Protein extracts from placental tissue were obtained after birth from healthy- (n = 11) and preeclamptic women (n = 13). Paired umbilical artery and vein serum samples from the neonates (n = 10) of healthy mothers were also analyzed. Multilevel modeling was used to determine the reference centiles. Differences between groups were analyzed using Student’s t-test.ResultsHealthy pregnant women at term (37–40 weeks) had significantly higher plasma levels of laeverin (mean 4.95 ± 0.32 ng/mL; p < 0.0001) compared to men (mean 0.18 ± 0.31 ng/mL), non-pregnant premenopausal women (mean 0.77 ± 0.26 ng/mL) and postmenopausal women (mean 0.57 ± 0.40 ng/mL). Maternal plasma laeverin levels decreased with advancing gestation, from 6.96 ± 0.32 ng/mL at 22–24 weeks to 4.95 ± 0.32 ng/mL at term (p < 0.0001) in uncomplicated pregnancies. Half of the women who developed preeclampsia had plasma laeverin levels below the 5th percentile at 22–24 weeks gestation. However, laeverin levels were 1.6 fold higher in preeclamptic compared to healthy placentas (p = 0.0071). Umbilical venous samples of healthy neonates (n = 38) had higher (p = 0.001) mean levels of laeverin (16.63 ± 0.73 ng/mL), compared to neonates of preeclamptic (n = 14) mothers (12.02 ± 1.00 ng/mL). Postpartum plasma levels of laeverin decreased in healthy and preeclamptic women with a half-life of 3 and 5 days, respectively.ConclusionsMaternal plasma levels of laeverin decrease with advancing gestation during the second half of normal pregnancy and lower levels measured at 22–24 weeks might be associated with the development of preeclampsia later in gestation.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal reference ranges for maternal plasma laeverin, and its role as a potential biomarker of preeclampsia

Nystad

Sitras

Flo

et al. 2016

BMC Pregnancy Childbirth

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“…An electronically pivotable bed designed for changing position without any active movement by the study participant was used. Hemodynamic parameters were measured using impedance cardiography (ICG) (Phillips Medical Systems, Androver, MA, USA) as described previously [24]. Baseline measurements were obtained after approximately 10 minutes of rest in a supine recumbent position with the upper part of the bed at a 45° tilt.…”

Section: Methodsmentioning

confidence: 99%

Effect of Passive Leg Raising on Systemic Hemodynamics of Pregnant Women: A Dynamic Assessment of Maternal Cardiovascular Function at 22–24 Weeks of Gestation

2014

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ObjectiveTo investigate functional hemodynamic response to passive leg raising in healthy pregnant women and compare it with non-pregnant controls.Materials and MethodsThis 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 measuresTrends 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.ResultsThe 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).ConclusionStatic 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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“…The hormonal and hemodynamic changes in the peripartum, delivery, and post-partum period may account for the association between SCAD and post-partum status. Hormonal changes during pregnancy have been shown to have effects on the arterial wall, possibly predisposing to dissection in the coronary vasculature, in conjunction with the increased cardiac output that occurs throughout pregnancy and especially during delivery (104–106). …”

Section: Scadmentioning

confidence: 99%

Coronary Artery Manifestations of Fibromuscular Dysplasia

Michelis

Olin

Kadian-Dodov

et al. 2014

Journal of the American College of Cardiology

123

105

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Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic “string of beads” that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies.

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A longitudinal study of the relationship between maternal cardiac output measured by impedance cardiography and uterine artery blood flow in the second half of pregnancy

Cited by 79 publications

References 35 publications

Longitudinal reference ranges for maternal plasma laeverin, and its role as a potential biomarker of preeclampsia

Longitudinal reference ranges for maternal plasma laeverin, and its role as a potential biomarker of preeclampsia

Effect of Passive Leg Raising on Systemic Hemodynamics of Pregnant Women: A Dynamic Assessment of Maternal Cardiovascular Function at 22–24 Weeks of Gestation

Coronary Artery Manifestations of Fibromuscular Dysplasia

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