Hemodynamic Adaptation during Pregnancy in Chronic Hypertension

Tihtonen, Kati; Kööbi, Tiit; Huhtala, Heini; Uotila, Jukka

doi:10.1080/10641950701436016

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…No significant difference between treated and untreated women could be detected. Previous trials reported conflicting results whether chronic hypertension impacts fetal outcome [ 29 , 30 ]. However, the difference in birthweight seems much more pronounced than in gestational age, which may indicate a growth restriction in these pathologies independent of gestational age.…”

Section: Discussionmentioning

confidence: 99%

Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome

Andreas

Kuessel

Kastl

et al. 2016

BMC Pregnancy Childbirth

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BackgroundPregnancy 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.MethodsWe 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.ResultsCardiac 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.ConclusionsCardiovascular 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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Section: Discussionmentioning

confidence: 99%

Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome

Andreas

Kuessel

Kastl

et al. 2016

BMC Pregnancy Childbirth

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“…; Tihtonen et al. ). In dogs, increases in ANP have been described as a response to increased atrial volume (Paganelli et al.…”

Section: Discussionmentioning

confidence: 97%

“…; Tihtonen et al. ; Abbott ; Blanco et al. ); and abnormalities related to ventricular change and pulmonary hypertension correlate with the levels of NT‐proBNP (Yoshimura et al.…”

Section: Discussionmentioning

confidence: 99%

Serum Levels of Cardiac Markers NT‐proANP and NT‐proBNP in Brachycephalic bitches at Different Gestational Stages

Feliciano

Uscátegui

Maciel

et al. 2016

Reprod Domestic Animals

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The aim of this study was to determine serum levels of natriuretic peptide precursors (NT-proANP and NT-proBNP) during pregnancy in brachycephalic bitches. Fifteen healthy multiparous bitches were selected for this prospective study. Serum levels of NT-proANP and NT-proBNP were measured during anoestrous and at 14, 35, 42, 49 and 56 days (2nd, 5th, 6th, 7th and 8th weeks) of pregnancy. Fourteen animals had normal gestations, and one bitch developed single foetus syndrome. The natriuretic peptide levels of this animal were not included in this study; however, it is important to report that its NT-proANP levels were four times greater than those of normal patients. There was no significant difference (p = 0.072) in NT-proBNP levels between anoestrous (0.20 ± 0.10 ng/ml) and the different pregnancy weeks (0.27 ± 0.12 ng/ml). There was a positive correlation (p < 0.0001) between NT-proANP and gestational age, and the levels of this marker increased significantly (p < 0.0001) during the 6th (0.26 ± 0.06 ng/ml), 7th (0.28 ± 0.04 ng/ml) and 8th weeks (0.29 ± 0.05 ng/ml) when compared to anoestrous (0.18 ± 0.02 ng/ml). NT-proANP serum levels are correlated with gestational development and may be indicative of cardiovascular adaptation in canine brachycephalic pregnancy.

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“…24,25 Pregnancies complicated by HDP are generally characterized by a significantly increased left ventricular mass, [26][27][28][29][30][31] concentric hypertrophy, 27,28,32 and increased SVR 13,26,30,31,33 compared with normotensive pregnancy. Specifically, pregnant women with chronic hypertension are characterized by persistent high SVR and reduced intravascular volume expansion throughout pregnancy compared with normotensive pregnancy 34 ; while evidence on cardiovascular changes in gestational hypertension is conflicting. 13,22,26,30,33,35,36 Stroke volume and myocardial performance index are expected to be reduced in pre-eclampsia compared with normotensive pregnancy.…”

Section: Cardiovascular Changes In Women With Hypertensive Disorders ...mentioning

confidence: 99%

Hypertensive disorders of pregnancy and long‐term cardiovascular health: FIGO Best Practice Advice

Poon

Nguyen‐Hoang

Smith

et al. 2023

Intl J Gynecology & Obste

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Hypertensive disorders of pregnancy (HDP) are the most common causes of maternal and perinatal morbidity and mortality. They are responsible for 16% of maternal deaths in high‐income countries and approximately 25% in low‐ and middle‐income countries. The impact of HDP can be lifelong as they are a recognized risk factor for future cardiovascular disease. During pregnancy, the cardiovascular system undergoes significant adaptive changes that ensure adequate uteroplacental blood flow and exchange of oxygen and nutrients to nurture and accommodate the developing fetus. Failure to achieve normal cardiovascular adaptation is associated with the development of HDP. Hemodynamic alterations in women with a history of HDP can persist for years and predispose to long‐term cardiovascular morbidity and mortality. Therefore, pregnancy and the postpartum period are an opportunity to identify women with underlying, often unrecognized, cardiovascular risk factors. It is important to develop strategies with lifestyle and therapeutic interventions to reduce the risk of future cardiovascular disease in those who have a history of HDP.

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Hemodynamic Adaptation during Pregnancy in Chronic Hypertension

Cited by 12 publications

References 37 publications

Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome

Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome

Serum Levels of Cardiac Markers NT‐proANP and NT‐proBNP in Brachycephalic bitches at Different Gestational Stages

Hypertensive disorders of pregnancy and long‐term cardiovascular health: FIGO Best Practice Advice

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