Objective To evaluate the maternal hemodynamic profile in women with a diagnosis of threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease.Methods Patients with a diagnosis of TPD were enrolled and assessed using a non-invasive method (USCOM (R)) for the determination of hemodynamic parameters. Vaginal and rectal swabs were taken, cervical length, blood inflammatory indices, fetal blood-vessel Doppler velocimetry were measured and gestational age at the time of delivery and neonatal outcomes were noted.Results A total of 68 patients were enrolled and included in the analysis. The population was divided into two groups according to total vascular resistance (TVR): Group A with a TVR of <= 1000 dynesxs/cm(5) (n=48) and Group B with a TVR of > 1000 dynesxs/cm(5) (n = 20). C-reactive protein (CRP) was higher in Group B than in Group A, suggesting a systemic inflammation status. Group B delivered earlier (32+4weeks vs 38+2weeks; P<0.01) and neonatal outcome was worse than in Group A. Significantly lower values of cardiac output, stroke volume, peak velocity of flow, velocity time integral, minute distance, stroke volume index, cardiac index, stroke work, cardiac power, inotropy index and potential-to-kinetic energy ratio were observed in Group B than in Group A.Conclusions Women with a diagnosis of TPD showing TVR values of > 1000 dynesxs/cm(5) and elevated levels of CRP are at high risk of preterm delivery. An impaired maternal cardiovascular adaptation during pregnancy in these patients might suggest a possible higher risk for subsequent future cardiovascular disease. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.

Valensise, H., Farsetti, D., Lo Presti, D., Pisani, I., Tiralongo, G.m., Gagliardi, G., et al. (2016). Preterm delivery and elevated maternal total vascular resistance: signs of suboptimal cardiovascular adaptation to pregnancy?. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 48(4), 491-495 [10.1002/uog.15910].

Preterm delivery and elevated maternal total vascular resistance: signs of suboptimal cardiovascular adaptation to pregnancy?

Valensise H.;Farsetti D.;
2016

Abstract

Objective To evaluate the maternal hemodynamic profile in women with a diagnosis of threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease.Methods Patients with a diagnosis of TPD were enrolled and assessed using a non-invasive method (USCOM (R)) for the determination of hemodynamic parameters. Vaginal and rectal swabs were taken, cervical length, blood inflammatory indices, fetal blood-vessel Doppler velocimetry were measured and gestational age at the time of delivery and neonatal outcomes were noted.Results A total of 68 patients were enrolled and included in the analysis. The population was divided into two groups according to total vascular resistance (TVR): Group A with a TVR of <= 1000 dynesxs/cm(5) (n=48) and Group B with a TVR of > 1000 dynesxs/cm(5) (n = 20). C-reactive protein (CRP) was higher in Group B than in Group A, suggesting a systemic inflammation status. Group B delivered earlier (32+4weeks vs 38+2weeks; P<0.01) and neonatal outcome was worse than in Group A. Significantly lower values of cardiac output, stroke volume, peak velocity of flow, velocity time integral, minute distance, stroke volume index, cardiac index, stroke work, cardiac power, inotropy index and potential-to-kinetic energy ratio were observed in Group B than in Group A.Conclusions Women with a diagnosis of TPD showing TVR values of > 1000 dynesxs/cm(5) and elevated levels of CRP are at high risk of preterm delivery. An impaired maternal cardiovascular adaptation during pregnancy in these patients might suggest a possible higher risk for subsequent future cardiovascular disease. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/40
English
maternal cardiac function
preterm labor
systemic peripheral resistance
Adult
C-Reactive Protein
Cardiovascular Diseases
Female
Heart
Hemodynamics
Humans
Maternal Age
Obstetric Labor, Premature
Pregnancy
Premature Birth
Risk Factors
Stroke Volume
Vascular Resistance
Valensise, H., Farsetti, D., Lo Presti, D., Pisani, I., Tiralongo, G.m., Gagliardi, G., et al. (2016). Preterm delivery and elevated maternal total vascular resistance: signs of suboptimal cardiovascular adaptation to pregnancy?. ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 48(4), 491-495 [10.1002/uog.15910].
Valensise, H; Farsetti, D; Lo Presti, D; Pisani, I; Tiralongo, Gm; Gagliardi, G; Vasapollo, B; Novelli, Gp
Articolo su rivista
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/303743
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 13
social impact