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Open Access Research article

Maternal venous hemodynamics in gestational hypertension and preeclampsia

Wilfried Gyselaers12*, Kathleen Tomsin3, Anneleen Staelens3, Tinne Mesens1, Jolien Oben1 and Geert Molenberghs4

Author Affiliations

1 Department of Obstetrics & Gynaecology, Ziekenhuis Oost, Limburg Schiepse Bos 6, 3600 Genk, Belgium

2 Department of Physiology, Hasselt University, Diepenbeek, Belgium

3 Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

4 Center for Medical Statistics, Hasselt University, Diepenbeek, Belgium

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BMC Pregnancy and Childbirth 2014, 14:212  doi:10.1186/1471-2393-14-212

Published: 23 June 2014

Abstract

Background

To evaluate characteristics of venous hemodynamics, together with cardiac and arterial function, in uncomplicated pregnancies (UP), non-proteinuric gestational hypertension (GH) and preeclampsia (PE).

Methods

In this observational cross-sectional study, venous hemodynamics was assessed using a standardised protocol for combined electrocardiogram (ECG)-Doppler ultrasonography, together with a non-invasive standardised cardiovascular assessment using impedance cardiography (ICG) in 13 women with UP, 21 with GH, 34 with late onset PE ≥ 34 w (LPE) and 22 with early onset PE < 34 w (EPE). ECG-Doppler parameters were impedance index at the level of hepatic veins (HVI) and renal interlobar veins (RIVI) together with venous pulse transit times (VPTT), as well as resistive and pulsatility index, and arterial pulse transit time (APTT) at the level of uterine arcuate arteries. ICG parameters were aortic flow velocity index (VI), acceleration index (ACI) and thoracic fluid content. Mann Whitney U-test, Kruskall-Wallis test and linear regression analysis with heteroskedastic variance was used for statistical analysis.

Results

RIVI in both kidneys was >15% higher (P ≤ .010) in LPE and EPE, as compared to GH and UP. Next to this, >30% lower values for VI and ACI (P ≤ .029), and > 15% lower values for APTT (P ≤ .012) were found in GH, LPE and EPE, as compared to GH.

Conclusion

In comparison to UP, similar abnormalities of central arterial function and APTT were found in GH, EPE and LPE. Proteinuria of LPE and EPE was associated with increased RIVI, this was not observed in GH.

Keywords:
Hemodynamics; Pregnancy; Hypertension; Preeclampsia