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http://hdl.handle.net/1942/12094
Title: | Time-interval between maternal electrocardiogram and venous Doppler waves in normal pregnancy and pre-eclampsia: a pilot study. | Authors: | TOMSIN, Kathleen Mesens, Tinne MOLENBERGHS, Geert Peeters, Louis GYSELAERS, Wilfried |
Issue Date: | 2010 | Publisher: | Georg Thieme Verlag KG Stuttgart - New York | Source: | ULTRASCHALL IN DER MEDIZIN, 2010(31). p. 1-7 | Abstract: | Purpose: To evaluate the time-interval between maternal electrocardiogram (ECG) and venous Doppler waves at different stages of uncomplicated pregnancy (UP) and in pre-eclampsia (PE). Materials and Methods: Cross-sectional pilot study in 40 uncomplicated singleton pregnancies, categorized in four groups of ten according to gestational age: 10-14 weeks (UP1), 18–23 weeks (UP2), 28-33 weeks (UP3) and 37 weeks (UP4) of gestation. A fifth group of ten women with PE was also included. A Doppler flow examination at the level or renal interlobar veins (RIV) and hepatic veins (HV) was performed according to a standard protocol, in association with a maternal ECG. The time-interval between the ECG P-wave and the corresponding A-deflection of the venous Doppler waves was measured (PA), expressed relative to the duration of the cardiac cycle (RR), and labelled PA/RR. Results: In hepatic veins, PA/RR is longer in UP4 than in UP1 (0.48 ± 0.15 versus 0.29 ± 0.09, p ≤ 0.001). When all UP groups were compared, PA/RR increased gradually with gestational age. In PE, HV PA/RR is shorter than in UP3 (0.25 ± 0.09 versus 0.42 ± 0.14, p < 0.01) and this difference persisted under anti-hypertensive treatment (0.28 ± 0.06 versus 0.42 ± 0.14, p ≤ 0.01, n = 6). Similar results were found in both kidneys. In UP1 but not in UP3 or UP4, HV PA/RR is shorter in liver than in left and right kidney (0.29 ± 0.09 versus 0.38 ± 0.12, p < 0.01, and versus 0.36 ± 0.09, p ≤ 0.01). Conclusion: PA/RR is organ-specific and gestation-dependent, and is considered to relate to venous vascular tone and/or intravascular filling. Increased values in advanced gestational stages are consistent with known features of maternal cardiovascular adaptation. Shorter values in pre-eclampsia are consistent with maternal cardiovascular maladaptation mechanisms. Our pilot study invites for more research into the relevance of the time-interval between maternal ECG and venous Doppler waves as a new parameter to study gestational cardiovascular (patho)physiology of the maternal venous compartment by Duplex sonography. | Keywords: | Doppler, ECG, Renal Interlobar Veins, Hepatic Veins, venous hemodynamics | Document URI: | http://hdl.handle.net/1942/12094 | ISSN: | 0172-4614 | e-ISSN: | 1438-8782 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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