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Gestational hypertensive disorders show unique patterns of circulatory deterioration with ongoing pregnancy.
Gyselaers, Wilfried; Vonck, Sharona; Staelens, Anneleen Simone; Lanssens, Dorien; Tomsin, Kathleen; Oben, Jolien; Dreesen, Pauline; Bruckers, Liesbeth.
Afiliación
  • Gyselaers W; Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek , Belgium.
  • Vonck S; Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
  • Staelens AS; Department Physiology, Hasselt University , Diepenbeek , Belgium.
  • Lanssens D; Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek , Belgium.
  • Tomsin K; Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
  • Oben J; Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
  • Dreesen P; Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek , Belgium.
  • Bruckers L; Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
Am J Physiol Regul Integr Comp Physiol ; 316(3): R210-R221, 2019 03 01.
Article en En | MEDLINE | ID: mdl-30673301
A combined assessment of heart, arteries, veins, and body fluid content throughout pregnancy has not yet been reported. We hypothesized that a gradual aggravation of circulatory dysfunction exists from the latent to the clinical phase of gestational hypertensive disease (GHD), and that pathways are unique for preeclampsia with early onset < 34 wk (EPE) and late onset ≥ 34 wk (LPE), and gestational hypertension (GH). Women with singleton pregnancy and no known diseases were invited for a prospective, observational study and had standardized sphygmomanometric blood pressure measurement, bioimpedance body water spectrum analysis, impedance cardiography for cardiac and arterial assessment, and combined Doppler-ECG of hepatic and renal interlobar veins and uterine arteries. Outcome was categorized as uncomplicated (UP, n = 1,700), EPE ( n = 87), LPE ( n = 218), or GH ( n = 188). A linear mixed model for repeated measurements, corrected for age, parity, and body mass index, was employed in SAS 9.4 to analyze trimestral changes within and between groups. From the first to the third trimester, body water increased in all groups, and an increasing number of abnormal parameters relative to UP occurred in all GHD. First-trimester blood pressure and peripheral resistance were higher in GHD than UP, together with increased uterine flow resistance and extracellular water in EPE, and with lower heart rate and aorta flow velocity in LPE. An overall gestational rise of body water volumes coexists with a gradual worsening of cardiovascular dysfunction in GHD, of which pathophysiological pathways are unique for EPE, LPE, and GH, respectively.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Inducida en el Embarazo / Hemodinámica Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Am J Physiol Regul Integr Comp Physiol Asunto de la revista: FISIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Inducida en el Embarazo / Hemodinámica Tipo de estudio: Observational_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Am J Physiol Regul Integr Comp Physiol Asunto de la revista: FISIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos