Maternal cardiovascular profiling in the first trimester of pregnancies complicated with gestation-induced hypertension or fetal growth retardation: a pilot study

Abstract

Objective: In this study, we determine whether maternal cardiovascular (CV) profiling can detect first trimester differences between women with uncomplicated pregnancies (UP) and those who will develop gestational hypertensive disorders (GHD) or normotensive fetal growth retardation (FGR). Methods: Cardiac, arterial, and venous function were evaluated in 242 pregnant women around 12 weeks of gestation, using impedance cardiography (ICG) and combined electrocardiogram Doppler ultrasonography. After postnatal determination of gestational outcome, first trimester measurements were compared between groups using Mann-Whitney U test for continuous data or Fisher's Exact test for categorical variables (SPSS 20.0). Results: Compared to UP, first trimester aortic flow velocity index [71 +/- 0.96 versus 61 +/- 4.91 1/1000/s (p = 0.016)], acceleration index [133 +/- 2.25 versus 106 +/- 11.26 1/100/s(2) (p = 0.023)] and Heather index [23.1 +/- 0.35 versus 19.2 +/- 1.70 Omega/s(2) (p = 0.019)] were lower in GHD pregnancies, and first trimester stroke volume [77 +/- 1.16 versus 67 +/- 3.97 ml (p = 0.033)] and cardiac output [7.3 +/- 0.10 versus 6.2 +/- 0.31 l/min (p = 0.025)] were lower in FGR pregnancies. Conclusions: Maternal CV function in the first trimester of pregnancy differs between UP and those destined to develop GHD or FGR. This can be assessed with non-invasive maternal CV profiling, opening perspectives for the application of this technique in early gestational screening for GHD and FGR.