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Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation
OBJECTIVE: To compare cardiac function, systemic hemodynamics and preload reserve of women with increased (cases) and normal (controls) uterine artery (UtA) pulsatility index (PI) at 22–24 weeks of gestation. MATERIALS AND METHODS: A prospective cross-sectional study of 620 pregnant women. UtA blood...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911143/ https://www.ncbi.nlm.nih.gov/pubmed/27308858 http://dx.doi.org/10.1371/journal.pone.0157916 |
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author | Vårtun, Åse Flo, Kari Widnes, Christian Acharya, Ganesh |
author_facet | Vårtun, Åse Flo, Kari Widnes, Christian Acharya, Ganesh |
author_sort | Vårtun, Åse |
collection | PubMed |
description | OBJECTIVE: To compare cardiac function, systemic hemodynamics and preload reserve of women with increased (cases) and normal (controls) uterine artery (UtA) pulsatility index (PI) at 22–24 weeks of gestation. MATERIALS AND METHODS: A prospective cross-sectional study of 620 pregnant women. UtA blood flow velocities were measured using Doppler ultrasonography, and PI was calculated. Mean UtA PI ≥ 1.16 (90th percentile) was considered abnormal. Maternal hemodynamics was investigated at baseline and during passive leg raising (PLR) using impedance cardiography (ICG). Preload reserve was defined as percent increase in stroke volume (SV) 90 seconds after passive leg raising compared to baseline. RESULTS: Mean UtA PI was 1.49 among cases (n = 63) and 0.76 among controls (n = 557) (p < 0.0001). Eighteen (28.6%) cases and 53 (9.5%) controls developed pregnancy complications (p <0.0001). The mean arterial pressure and systemic vascular resistance were 83 mmHg and 1098.89±293.87 dyne s/cm(5) among cases and 79 mmHg and 1023.95±213.83 dyne s/cm(5) among controls (p = 0.007 and p = 0.012, respectively). Heart rate, SV and cardiac output were not different between the groups. Both cases and controls responded with a small (4–5%) increase in SV in response to PLR, but the cardiac output remained unchanged. The preload reserve was not significantly different between two groups. CONCLUSION: Pregnant women with abnormal UtA PI had higher blood pressure and systemic vascular resistance, but similar functional hemodynamic profile at 22–24 weeks compared to controls. Further studies are needed to clarify whether functional hemodynamic assessment using ICG can be useful in predicting pregnancy complications. |
format | Online Article Text |
id | pubmed-4911143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-49111432016-07-06 Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation Vårtun, Åse Flo, Kari Widnes, Christian Acharya, Ganesh PLoS One Research Article OBJECTIVE: To compare cardiac function, systemic hemodynamics and preload reserve of women with increased (cases) and normal (controls) uterine artery (UtA) pulsatility index (PI) at 22–24 weeks of gestation. MATERIALS AND METHODS: A prospective cross-sectional study of 620 pregnant women. UtA blood flow velocities were measured using Doppler ultrasonography, and PI was calculated. Mean UtA PI ≥ 1.16 (90th percentile) was considered abnormal. Maternal hemodynamics was investigated at baseline and during passive leg raising (PLR) using impedance cardiography (ICG). Preload reserve was defined as percent increase in stroke volume (SV) 90 seconds after passive leg raising compared to baseline. RESULTS: Mean UtA PI was 1.49 among cases (n = 63) and 0.76 among controls (n = 557) (p < 0.0001). Eighteen (28.6%) cases and 53 (9.5%) controls developed pregnancy complications (p <0.0001). The mean arterial pressure and systemic vascular resistance were 83 mmHg and 1098.89±293.87 dyne s/cm(5) among cases and 79 mmHg and 1023.95±213.83 dyne s/cm(5) among controls (p = 0.007 and p = 0.012, respectively). Heart rate, SV and cardiac output were not different between the groups. Both cases and controls responded with a small (4–5%) increase in SV in response to PLR, but the cardiac output remained unchanged. The preload reserve was not significantly different between two groups. CONCLUSION: Pregnant women with abnormal UtA PI had higher blood pressure and systemic vascular resistance, but similar functional hemodynamic profile at 22–24 weeks compared to controls. Further studies are needed to clarify whether functional hemodynamic assessment using ICG can be useful in predicting pregnancy complications. Public Library of Science 2016-06-16 /pmc/articles/PMC4911143/ /pubmed/27308858 http://dx.doi.org/10.1371/journal.pone.0157916 Text en © 2016 Vårtun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Vårtun, Åse Flo, Kari Widnes, Christian Acharya, Ganesh Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title | Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title_full | Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title_fullStr | Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title_full_unstemmed | Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title_short | Static and Functional Hemodynamic Profiles of Women with Abnormal Uterine Artery Doppler at 22–24 Weeks of Gestation |
title_sort | static and functional hemodynamic profiles of women with abnormal uterine artery doppler at 22–24 weeks of gestation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911143/ https://www.ncbi.nlm.nih.gov/pubmed/27308858 http://dx.doi.org/10.1371/journal.pone.0157916 |
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