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Early‐pregnancy changes in cardiac diastolic function in women with recurrent pre‐eclampsia and in previously pre‐eclamptic women without recurrent disease
Author(s) -
Sep SJS,
Schreurs MPH,
Bekkers SCAM,
Kruse AJ,
Smits LJ,
Peeters LLH
Publication year - 2011
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2011.02951.x
Subject(s) - eclampsia , medicine , pregnancy , gestation , diastole , obstetrics , cardiac function curve , preeclampsia , cardiology , retrospective cohort study , vascular resistance , hemodynamics , heart failure , blood pressure , genetics , biology
Please cite this paper as: Sep S, Schreurs M, Bekkers S, Kruse A, Smits L, Peeters L. Early‐pregnancy changes in cardiac diastolic function in women with recurrent pre‐eclampsia and in previously pre‐eclamptic women without recurrent disease. BJOG 2011;118:1112–1119. Objective To compare early‐pregnancy changes in cardiac diastolic function between formerly pre‐eclamptic women with (RECUR) and without (NORECUR) recurrent pre‐eclampsia. Design Retrospective observational cohort study. Setting Tertiary referral centre. Population Pregnant women with a history of early‐onset pre‐eclampsia ( n = 34). Methods The peak mitral filling velocity in early diastole (E) and at atrial contraction (A), and the E/A ratio were assessed before and at 12, 16 and 20 weeks of gestation in the next pregnancy. Differences in early‐pregnancy alterations between women with (RECUR) and without (NORECUR) recurrent pre‐eclampsia were evaluated by use of mixed design analysis of covariance. Main outcome measures Cardiac function and recurrent pre‐eclampsia. Results In ten women (29%) pre‐eclampsia recurred. By 12 weeks of gestation the E/A ratio had increased in the RECUR group, but not in the NORECUR group ( P < 0.01). Moreover, from 16 weeks of gestation onwards, the RECUR group had a lower cardiac output and higher systemic vascular resistance as compared with the NORECUR group ( P < 0.05). Conclusion Our results suggest that formerly pre‐eclamptic women destined to develop recurrent pre‐eclampsia differ from their counterparts who do not develop recurrent pre‐eclampsia by impaired first‐trimester adaptation of cardiac diastolic function.