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Maternal cardiac function in normotensive and pre‐eclamptic intrauterine growth restriction
Author(s) -
Bamfo J. E. A. K.,
Kametas N. A.,
Chambers J. B.,
Nicolaides K. H.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5311
Subject(s) - medicine , intrauterine growth restriction , cardiology , diastole , stroke volume , gestation , eclampsia , vascular resistance , cardiac output , blood pressure , pregnancy , preeclampsia , doppler echocardiography , cardiac function curve , doppler imaging , heart rate , heart failure , genetics , biology
Objectives To compare maternal cardiac function between pregnancies complicated by normotensive and pre‐eclamptic intrauterine growth restriction (IUGR). Methods Two‐dimensional Doppler echocardiography and Doppler tissue imaging (DTI) were used to examine 19 pregnant women with IUGR and 17 with pre‐eclampsia complicated by IUGR at 20–38 weeks of gestation. Indices were converted into differences in SDs from the expected normal mean for gestation ( Z ‐scores) and compared. Results With respect to normal pregnancy, in the normotensive IUGR compared with the pre‐eclamptic IUGR group, there were similar reductions in maternal cardiac output ( Z ‐score, − 1.71 vs. − 1.37, P = 0.26) and heart rate ( Z ‐score, − 3.67 vs. − 9.43, P = 0.1) and a similar increase in total vascular resistance ( Z ‐score, 2.91 vs. 3.93, P = 0.05). There was also a greater decrease in stroke volume ( Z ‐score, − 1.72 vs. − 0.69, P = 0.01), a smaller increase in mean arterial pressure ( Z ‐score, 0.73 vs. 2.94, P < 0.01) and a smaller decrease in DTI systolic velocity at the lateral mitral margin ( Z ‐score, − 0.4 vs. − 1.42, P = 0.02). In terms of diastolic function, there was a smaller transmitral late diastolic velocity ( Z ‐score, 0.04 vs. 0.93, P = 0.03) and a greater DTI early diastolic velocity at the lateral mitral margin ( Z ‐score, − 0.17 vs. − 1.6, P < 0.01). Conclusions In normotensive IUGR and pre‐eclamptic IUGR there is a similar alteration in maternal left ventricular systolic function, but there is greater impairment in maternal diastolic function in pre‐eclamptic IUGR. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.