TITLE:
Early pregnancy maternal cardiovascular profiling in the prediction of hypertensive disease in pregnancy
AUTHORS:
Jennifer Hogan, Vicky O’Dwyer, Nadine Farah, Mairead M. Kennelly, Michael J. Turner, Bernard Stuart
KEYWORDS:
Pre-Eclampsia; Gestational Hypertension; Arterial Wall Elasticity; Pulse Pressure Wave Analysis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.2,
February
11,
2014
ABSTRACT:
Prediction of hypertensive disease in pregnancy remains
challenging. Risk factor based screening utilizing history, physical
characteristics, uterine artery Doppler and serum markers have been used with
varying success. As hypertension in pregnancy appears to be associated with
changes in the maternal vasculature, we have investigated the utility of
maternal arterial elasticity measurement, prior to 20 weeks gestation, in the
prediction of hypertensive disease in pregnancy. A HDI/Pulsewave CR2000
Research Cardiovascular Profiling System was used to obtain radial artery pulse
pressure waveforms from 623 Caucasian women at the time of their first
antenatal visit. Outcome data were available in 610 cases and these comprised
the study group. The results showed that women who subsequently developed
gestational hypertension (n = 20) had higher baseline systolic, diastolic and
pulse pressure values (though within the normal range) but similar arterial
elasticity to those patients who did not develop hypertension. Women who later
developed pre-eclampsia (n = 23) had, in addition, reduced large artery
elasticity and increased systemic vascular resistance compared with women who
did not develop hypertension. The
measurement of maternal radial artery elasticity in early pregnancy may provide an additional refinement in screening for
hypertensive disease, particularly pre-eclampsia, in pregnancy.