H3. Maternal haedomynamics in hypertensive disorders of pregnancy: a case control study.

BACKGROUND: Hypertensive disorders in pregnancy (HDP) are associated with altered maternal haemodynamics, which can be investigated using non-invasive methodologies.

OBJECTIVE: To assess maternal haemodynamics using USCOM 1A® in patients presenting with non-medicated, hypertensive disorders of pregnancy and normotensive controls.

METHODS: A prospective, nested case-control study in 65 patients presenting with unmedicated hypertension. The control population consisted of 400 subjects who did not have a history of hypertensive disorders. The control population was matched for maternal and gestational age.

RESULTS: Hypertensive cases had a significantly lower stroke volume (74 versus 79 mL), lower cardiac output (6.07 versus 6.75 L/min), higher total peripheral resistance (1466 versus 1084 dyn·s·cm(5)) and higher BMI (32.3 versus 29.2; p < 0.05 for all). Given the differences in anthropometric parameters between the cohorts, haemodynamic indices were corrected for body surface area. The haemodynamic changes persisted despite this allometric correction with lower stroke volume index (36.9 versus 41.3 mL/m(2)), lower cardiac index (3.02 versus 3.51 L/min/m(2)) and higher TPR Index (2928 versus 2091 dyn·s·cm(5)/m(2)) in the hypertensive group (p < 0.05 for all).

CONCLUSION: Aberrations in maternal haemodynamics are found in women presenting with hypertensive disorders of pregnancy. Investigation of maternal haemodynamics using non-invasive methods support existing data on cardiac dysfunction in HDP.