Doppler Measurement of Renal Interlobar Vein Impedance Index in Uncomplicated and Preeclamptic Pregnancies

Gyselaers, Wilfried; Molenberghs, Geert; Mieghem, W. Van; Ombelet, Willem

doi:10.1080/10641950802233056

Cited by 30 publications

(34 citation statements)

References 26 publications

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“…Also, an increase in the femoral venous pressure during pregnancy has been described [29]. Next to this, a different pattern in Doppler waves in uncomplicated pregnancies versus hypertensive gestational diseases is described [30], [31]. Sugerman hypothesized that an excessively high IAP during pregnancy compresses the venous system, which might contribute to symptoms known as preeclampsia and HELLP-syndrome [11].…”

Section: Discussionmentioning

confidence: 99%

Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

et al. 2014

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ObjectiveTo determine intra-abdominal pressure (IAP) and to evaluate the reproducibility of IAP-measurements using the Foley Manometer Low Volume (FMLV) in term uncomplicated pregnancies before and after caesarean section (CS), relative to two different reference points and to non-pregnant values.DesignObservational cohort study.SettingSecondary level referral center for feto-maternal medicine.PopulationTerm uncomplicated pregnant women as the case-group and non-pregnant patients undergoing a laparoscopic assisted vaginal hysterectomy (LAVH) as control group.MethodsIAP was measured in 23 term pregnant patients, before and after CS and in 27 women immediately after and 1 day after LAVH. The midaxillary line was used as zero-reference (IAPMAL) in all patients and in 13 CS and 13 LAVH patients, the symphysis pubis (IAPSP) was evaluated as additional zero-reference. Intraobserver correlation (ICC) was calculated for each zero-reference. Paired student's t-tests were performed to compare IAP values and Pearson's correlation was used to assess correlations between IAP and gestational variables.Main outcome measuresICC before and after surgery, IAP before and after CS, IAP after CS and LAVH.ResultsThe ICC for IAPMAL before CS was lower than after (0.71 versus 0.87). Both mean IAPMAL and IAPSP were significantly higher before CS than after: 14.0±2.6 mmHg versus 9.8±3.0 mmHg (p<0.0001) and 8.2±2.5 mmHg versus 3.5±1.9 mmHg (p = 0.010), respectively. After CS, IAP was not different from values measured in the LAVH-group.ConclusionIAP-measurements using FMLV is reproducible in pregnant women. Before CS, IAP is increased in the range of intra-abdominal hypertension for non-pregnant individuals. IAP significantly decreases to normal values after delivery.

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Section: Discussionmentioning

confidence: 99%

Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

et al. 2014

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“…All patients had all assessments in 1 session and at least once during pregnancy. A standardized protocol with known inter‐ and intra‐observer correlations was used as reported in previous studies …”

Section: Methodsmentioning

confidence: 99%

Obesity in pregnancy causes a volume overload in third trimester

Vonck

Lanssens

Staelens

et al. 2019

Eur J Clin Investigation

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Background Obesity is a major risk factor for cardiovascular diseases. In this study, we aimed to investigate the maternal circulatory differences during pregnancy between obese and normal weight women. Materials and methods The functioning of the maternal circulation (arteries, veins, heart and body fluid) was assessed by ECG‐Doppler ultrasound, impedance cardiography (ICG) and bio‐impedance during pregnancy in obese women (BMI ≥30 kg/m2) and normal weight, nonobese women (BMI 20‐25 kg/m2). In this observational study, 232 assessments were performed in the obese group, whereas 919 assessments were performed in the nonobese group. Results Relative to nonobese women, the overall cardiovascular function in obese women during first and second trimester is consistent with a high volume/low‐resistance circulation. In third trimester, cardiac output of obese women decreases from 9.2 (8.2‐10.7) L/min to 8.5 (7.6‐9.6) L/min (P = .037) whereas this is not true in the nonobese women (from 7.8 (7‐8.5) L/min to 7.8 (6.8‐8.9) L/min, P = .536). Simultaneously, the persistently lower peripheral vascular resistance in obese vs nonobese women disappears (880 (761‐1060) dyn.sec/cm5 vs 928 (780‐1067). Conclusions The circulatory gestational adaptations between nonobese and obese women were generally similar. The findings in the third trimester suggest that a pregnancy in obese women start as a state of high volume/low resistance, gradually shifting to a volume overload with decrease of cardiac output and disappearance of low vascular resistance. This evolution makes obese women vulnerable for gestational hypertensive diseases.

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“…After informed consent, all women had ECG-D investigations in supine position at the level of hepatic veins (HV), renal interlobar veins (RIV) of both kidneys, and left and right arcuate uterine arteries as reported [22], using a 3.5 – 5 MHz probe (Toshiba Aplio Mx © , Toshiba Medical Systems nv, Sint-Stevens-Woluwe, Belgium). Uterine arcuate arteries were preferred over uterine arteries for their intra-parenchymatous localization, comparable with the localization of hepatic and renal interlobar veins [15].…”

Section: Methodsmentioning

confidence: 99%

Maternal venous hemodynamics in gestational hypertension and preeclampsia

Gyselaers

Tomsin

Staelens

et al. 2014

BMC Pregnancy Childbirth

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BackgroundTo evaluate characteristics of venous hemodynamics, together with cardiac and arterial function, in uncomplicated pregnancies (UP), non-proteinuric gestational hypertension (GH) and preeclampsia (PE).MethodsIn 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.ResultsRIVI 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.ConclusionIn 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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Doppler Measurement of Renal Interlobar Vein Impedance Index in Uncomplicated and Preeclamptic Pregnancies

Cited by 30 publications

References 26 publications

Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

Obesity in pregnancy causes a volume overload in third trimester

Maternal venous hemodynamics in gestational hypertension and preeclampsia

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