Cardiac adaptation to pregnancy in women with a history of preeclampsia and a subnormal plasma volume

Reprod Sci. 2008 Dec;15(10):1059-65. doi: 10.1177/1933719108322427. Epub 2008 Oct 20.

Abstract

In former preeclamptics, a subnormal plasma volume (LPV) predisposes to hemodynamic maladaptation to pregnancy. Here, we assessed the initial cardiovascular response to pregnancy in LPV (n = 20), in former preeclamptics with normal plasma volume (NPV) (n = 35) and in parous controls (CONTR) (n = 9) by echocardiography, blood pressure and heart rate (HR), before pregnancy, and by 5 and 7 weeks amenorrhea. Data analysis was by nonparametric tests. LPV differed from NPV and CONTR, by a consistently lower E/A ratio (ratio of peak mitral flow velocity in early diastole [E] and that during atrial contraction [A]) and an early-pregnancy rise in left atrial diameter (LAD). Both NPV and LPV differed from CONTR by an early-pregnancy rise in HR. The consistently lower E/A ratio together with the early-pregnancy LAD rise in LPV indicate diastolic dysfunction. The early-pregnancy rise in HR suggests sympathetic dominance in the autonomic control of the circulation.

Publication types

  • Comparative Study

MeSH terms

  • Adaptation, Physiological / physiology*
  • Adult
  • Blood Pressure / physiology*
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology*
  • Humans
  • Hypovolemia / complications
  • Hypovolemia / physiopathology*
  • Plasma Volume / physiology
  • Pre-Eclampsia / physiopathology*
  • Pregnancy / physiology*
  • Pregnancy Complications, Cardiovascular / physiopathology