TY - JOUR
T1 - Maternal cardiac adaptation to subsequent pregnancy in formerly pre-eclamptic women according to recurrence of pre-eclampsia
AU - Ghossein-Doha, C.
AU - Spaanderman, M. E. A.
AU - Al Doulah, R.
AU - Van Kuijk, S. M.
AU - Peeters, L. L. H.
PY - 2016/1
Y1 - 2016/1
N2 - Objectives Left-ventricular remodeling in women with pre-eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early-onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early-onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy. Methods In 51 women with a history of early-onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t-test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy-induced cardiac adaptive response using repeated-measures ANOVA. Results PE recurred in 14/51 (27%) women. Preconception, the recurrent-PE group differed from the non-recurrent-PE group by having a lower left-ventricular mass (LVM) index (28 vs 32 g/m(2.7), P<0.05) and stroke volume (68 vs 77 mL, P<0.05), and a higher resting heart rate (71 vs 64 bpm, P<0.05). Despite these prepregnancy differences, the pregnancy-induced pattern of cardiac adaptive response was comparable in the two subgroups. After excluding hypertensive women, prepregnancy values for the LVM index remained significantly lower in the recurrent-PE group. Conclusions Women with recurrent PE differed from the non-recurrent-PE group by having a lower LVM index and stroke volume, and a higher heart rate, but they responded to their subsequent pregnancy with a similar pattern of cardiac adaptation. ISUOG. Published by John Wiley & Sons Ltd.
AB - Objectives Left-ventricular remodeling in women with pre-eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early-onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early-onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy. Methods In 51 women with a history of early-onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t-test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy-induced cardiac adaptive response using repeated-measures ANOVA. Results PE recurred in 14/51 (27%) women. Preconception, the recurrent-PE group differed from the non-recurrent-PE group by having a lower left-ventricular mass (LVM) index (28 vs 32 g/m(2.7), P<0.05) and stroke volume (68 vs 77 mL, P<0.05), and a higher resting heart rate (71 vs 64 bpm, P<0.05). Despite these prepregnancy differences, the pregnancy-induced pattern of cardiac adaptive response was comparable in the two subgroups. After excluding hypertensive women, prepregnancy values for the LVM index remained significantly lower in the recurrent-PE group. Conclusions Women with recurrent PE differed from the non-recurrent-PE group by having a lower LVM index and stroke volume, and a higher heart rate, but they responded to their subsequent pregnancy with a similar pattern of cardiac adaptation. ISUOG. Published by John Wiley & Sons Ltd.
KW - cardiac adaptation
KW - left ventricular geometry
KW - left ventricular mass
KW - pre-eclampsia
KW - recurrent pre-eclampsia
U2 - 10.1002/uog.15752
DO - 10.1002/uog.15752
M3 - Article
C2 - 26395883
SN - 0960-7692
VL - 47
SP - 96
EP - 103
JO - Ultrasound in Obstetrics & Gynecology
JF - Ultrasound in Obstetrics & Gynecology
IS - 1
ER -