G5. 12-week cardiovascular profiles differ between patients with essential hypertension, gestational hypertension, late preeclampsia and intra-uterine growth retardation

Abstract

Introduction: Maternal cardiovascular adaptations are mandatory for a normal course of pregnancy. Disturbed adaptations predispose to gestational complications further in pregnancy such as hypertension disorders and/or fetal growth restriction. We aim to explore the early gestational cardiovascular profile in uncomplicated pregnancy, in gestational hypertensive disorders and isolated intra-uterine growth retardation.

Methods: Cardiovascular assessments were done using a standard protocol with impedance cardiography (Niccomo, SonoSite, MedisMedinizinischeMesstechnik GmbH, Ilmenau, Germany) and bio-impedance (Maltron BIOSCAN 920-II; Maltron International LTD, Essex, UK) around 12 weeks of gestation. Only singleton pregnancies were included. After delivery, gestational outcome was categorized in essential hypertension (EH), gestational hypertension (GH), early preeclampsia (EPE), late preeclampsia (LPE), HELLP, intra-uterine growth retardation (IUGR; <10th percentile) or uncomplicated pregnancy (UP). Independent sampled t-tests at nominal level a < 0.05 were performed using SPSS for comparison between UP and other groups. Pathologies with <5 inclusions were not considered.

Results: A total of 777 women were measured: 17 EH, 21 GH, 19 LPE, 74 IUGR and 643 UP. Three patients were excluded from the diagnosis HELLP (n = 1) and early preeclampsia (n = 2). Results are shown in Table 1. Parameters are marked " or # when measurements in pathology groups were higher (") or lower (#) then in UP. The combination of abnormal parameters is different between groups.

Conclusions: Cardiovascular profiling around 12 weeks could be useful to specify the type of cardiovascular dysfunction before the onset of gestational hypertensive disorder and/or a growth restriction.