A Longitudinal Study of the Maternal Cardiovascular Adaptation to Spontaneous and Assisted Conception Pregnancies

Abstract

Objective: To determine the sequence and extent of maternal cardiovascular adaptation in an integrated way in spontaneous and assisted conception pregnancies Methods: Cardiovascular assessments were performed pre-pregnancy, during pregnancy and 6 weeks post delivery in women with normal spontaneously conceived singleton pregnancies (n = 13); singleton IVF pregnancies (n = 5); singleton OD pregnancies (n = 4); and multiple pregnancies (n = 6). Results: The OD singleton pregnancies had a significantly higher diastolic and mean blood pressure (BP) than the normal singleton pregnancies at 10 weeks gestation (p = 0.010 and 0.008, respectively), and the multiple pregnancy group had a higher systolic and mean BP at 16 weeks gestation than the IVF singleton pregnancy group (p = 0.045 and 0.033, respectively). The multiple pregnancy group had higher heart rate (HR) at 16 weeks gestation (p = 0.010), higher fractional shortening (FS) at 16 weeks gestation (p = 0.006), and higher left ventricular (LV) mass at 26 weeks gestation (p = 0.049) than the IVF singleton pregnancy group. The rate of change of LV mass was correlated to the rate of change of the blood pressure (r = 0.725, p = 0.005 for mean BP) and inversely correlated to the rate of change of fractional shortening (r = 0.767, and p = 0.002). Conclusion: Ovum donation pregnancies are associated with higher BP in early pregnancy, whilst multiple pregnancies are associated with higher BP, FS and LV mass in later pregnancy.

Keywords:

• Cardiovascular
• Corpus luteum
• Echocardiography
• Feto-placental unit