Umbilical Blood Flow Correlated to Maternal Hemodynamics in Severe Preeclampsia

Abstract

Background: As there are conflicting results concerning maternal hemodynamics in preeclampsia, this study aimed to evaluate the maternal hemodynamic factors (cardiac output, mean arterial blood pressure, and total peripheral resistance) and put them in relation to fetal blood flow velocities in the umbilical artery.

Methods: Nine primiparous women with severe preeclampsia were compared with 9 normotensive controls matched for age and gestational age. The maternal cardiac output was measured by echocardiography, and the fetal flow velocities using an ultrasound-Doppler technique. The women were examined during the last trimester and also 6-12 months postdelivery for comparison of pregnant and nonpregnant status.

Results: The preeclamptic women who bore small-for-gestational-age (SGA) fetuses had significantly lower cardiac output and higher total peripheral resistance than the normotensive women, but the preeclamptic women with appropriate-for-gestational-age (AGA) fetuses had normal or supernormal cardiac output and normal total peripheral resistance during pregnancy. The flow velocity pattern of the umbilical artery was pathological in cases with SGA fetuses and normal in the AG A cases.

Conclusions: There seems to be a relation between low maternal cardiac output and small-for-gestational-age fetuses with pathological systolic/diastolic ratio of the umbilical artery.

Key Words:

• Doppler ultrasound
• Echocardiography
• Fetal circulation
• Maternal hemodynamics
• Preeclampsia