Mid‐gestational maternal cardiovascular profile in preterm and term pre‐eclampsia: a prospective study

Objective Pre‐eclampsia (PE) is associated with maternal cardiac remodelling and biventricular diastolic dysfunction. Preterm PE alone can also be associated with severe left ventricular hypertrophy and biventricular systolic dysfunction. The aim of this study was to assess whether the maternal card...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2013-03, Vol.120 (4), p.496-504
Main Authors: Melchiorre, K, Sutherland, G, Sharma, R, Nanni, M, Thilaganathan, B
Format: Article
Language:English
Subjects:
Adult
Cardiac remodelling
Cardiovascular system
Case-Control Studies
chamber dysfunction
echocardiography
Female
Hemodynamics
Humans
myocardial dysfunction
Pathology
Physiology
Pre-Eclampsia - etiology
Pre-Eclampsia - physiopathology
Preeclampsia
Pregnancy
Pregnancy Complications, Cardiovascular
Pregnancy Trimester, Second
pre‐eclampsia
Prospective Studies
Risk Factors
strain rate
Stress, Physiological - physiology
Systole - physiology
tissue Doppler
Ventricular Dysfunction, Left - complications
Ventricular Dysfunction, Left - physiopathology
Ventricular Remodeling - physiology
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Summary:Objective Pre‐eclampsia (PE) is associated with maternal cardiac remodelling and biventricular diastolic dysfunction. Preterm PE alone can also be associated with severe left ventricular hypertrophy and biventricular systolic dysfunction. The aim of this study was to assess whether the maternal cardiovascular profile at mid‐gestation in nulliparous normotensive women differs in women destined to develop preterm PE versus those who will develop PE at term. Design Prospective study. Setting Tertiary referral university centre. Population A total of 269 women, including 152 at increased risk of developing PE as determined by mid‐gestational uterine artery Doppler assessment. Methods Women underwent blood pressure profiling, echocardio‐graphy, cardiac tissue Doppler and strain rate analysis at 20–23 weeks of gestation. Main outcome measures Mid‐gestational cardiovascular profile in women with normal pregnancy and those that subsequently developed preterm or term PE. Results Pre‐eclampsia subsequently developed in 46 women, including 18 with preterm PE. Women who subsequently developed PE, irrespective of gestation, had evidence of left ventricular concentric remodelling (33%) which was not found in the control women (P 
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.12068