Maternal Central Hemodynamics in Hypertensive Disorders of Pregnancy

Bosio, P.; McKenna, Peter; Conroy, Ronán; O’Herlihy, Colm

doi:10.1097/00006250-199912000-00014

Cited by 239 publications

(215 citation statements)

References 23 publications

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“…21,22 Although some echocardiographic studies showed that women developing hypertensive complications during pregnancy may have different LA dimensions than controls, [23][24][25][26] the potential link between LA abnormality detected early in pregnancy by echocardiography or ECG and development of hypertensive disorders remains elusive. However, some possible mechanisms are supported by epidemiological data and experimental models.…”

Section: Discussionmentioning

confidence: 99%

Additive value of standard ECG for the risk prediction of hypertensive disorders during pregnancy

Angeli

Verdecchia²,

Narducci

et al. 2011

Hypertens Res

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Prediction of hypertensive complications during pregnancy remains limited, especially in healthy and initially normotensive women. We conducted a prospective screening study for hypertensive complications in pregnant women. We studied 221 nulliparous healthy and normotensive women with singleton pregnancies whose first routine visit was carried out before the twelfth week of gestation. We tested several demographic, clinical and laboratory variables as predictors of a composite pool of prespecified events, including gestational hypertension, preeclampsia or eclampsia. We analyzed the potential additive role of ECG in the identification of women at increased risk of hypertensive disorders. Mean age at entry was 30 years. During pregnancy, there were 28 prespecified events (22 women with gestational hypertension, 5 with preeclampsia and 1 with eclampsia). In univariate analyses, blood pressure (BP), weight, body mass index (BMI) and left atrial (LA) abnormality detected by ECG in lead V 1 showed an association with the risk of hypertensive disorders (all Po0.05). In a multivariable analysis, only mean BP (OR: 3.08, 95% confidence interval (CI): 1.61-5.92; P¼0.001 for each 10 mm Hg increase) and LA abnormality in lead V 1 (OR: 4.35, 95% CI: 1.84-10.31; P¼0.001) were independent predictors of hypertensive disorders. The final model discriminated well between women who developed hypertensive disorders and women who remained normotensive (AUC¼0.75; 95% CI: 0.67-0.84; Po0.0001). This study suggests that standard ECG is valuable to refine risk stratification for hypertensive disorders in initially normotensive pregnant women. LA abnormality, easily detected by simple visual inspection of the traditional ECG, and mean arterial pressure (MAP), allows a rapid and effective risk stratification for hypertensive disorders.

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Section: Discussionmentioning

confidence: 99%

Additive value of standard ECG for the risk prediction of hypertensive disorders during pregnancy

Angeli

Verdecchia²,

Narducci

et al. 2011

Hypertens Res

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“…10 In contrast late-PE, which is usually associated with normal placentation and fetal growth, 11,12 is thought to be a manifestation of an underlying metabolic disorder with increased insulin resistance. [13][14][15] Insulin-like growth factor-binding protein 3 (IGFBP-3) belongs to the family of IGFBPs, which determine the bioavailability and activity of the IGFs. 16,17 In the circulation, IGFBP-3 binds to approximately 95% of IGF-I and IGF-II and this complex prolongs the half-life of IGFs and protects them from degradation.…”

Section: Introductionmentioning

confidence: 99%

Maternal serum insulin-like growth factor-binding protein-3 (IGFBP-3) at 11–13 weeks in preeclampsia

et al. 2011

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“…They concluded that measurement of CO in the second trimester identified women at risk for PE and treatment with atenolol decreased the incidence of PE. Bosio 13 conducted a longitudinal study of 400 primigravidae who were monitored throughout pregnancy using doppler echocardiography to document maternal central hemodynamics during preclinical and clinical phases of nonprotienuric gestational hypertension and PE. Multinomial logistic regression was used to identify variables associated with risk of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Prediction of maternal disorders by serial cardiac output estimation during pregnancy.

Singam¹,

Chhabra²,

Namgyal³

2012

Int J of Biomed & Adv Res

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In pregnancy there is increased blood volume, heart rate (HR), stroke volume (SV), and cardiac output (CO).Present study was to assess the predictive value of serial measurements of cardiac output between 8 -32 weeks of pregnancy for prediction of maternal disorders. Cardiac output was measured by thoracic electrical impedance plethysmography at 10 ± 2 weeks, 14 ± 2 weeks, 18 ± 2 weeks, 22 ± 2 weeks, 26 ± 2 weeks and 30 ± 2 weeks of pregnancy. These women were followed till 7 days post-partum. Pregnant women having high cardiac output developed hypertensive disorders and those having low cardiac output developed intrauterine growth restriction and oligohydramnios.

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Maternal Central Hemodynamics in Hypertensive Disorders of Pregnancy

Cited by 239 publications

References 23 publications

Additive value of standard ECG for the risk prediction of hypertensive disorders during pregnancy

Additive value of standard ECG for the risk prediction of hypertensive disorders during pregnancy

Maternal serum insulin-like growth factor-binding protein-3 (IGFBP-3) at 11–13 weeks in preeclampsia

Prediction of maternal disorders by serial cardiac output estimation during pregnancy.

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