Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 11 , ISSUE 2 ( March-April, 2019 ) > List of Articles


Hemodynamic Profile and Cardiac Morphometry in Normotensive and Severe Preeclamptic Pregnant Women

Peby Lestari, Edo Alexander

Keywords : Cardiac morphometry, Early onset PE, Hemodynamic profile, Late-onset PE, Normotensive

Citation Information : Lestari P, Alexander E. Hemodynamic Profile and Cardiac Morphometry in Normotensive and Severe Preeclamptic Pregnant Women. J South Asian Feder Obs Gynae 2019; 11 (2):113-119.

DOI: 10.5005/jp-journals-10006-1677

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Objective: To identify the differences in hemodynamic profile and morphometric changes of maternal heart in normotensive pregnant women and severe preeclampsia. Materials and methods: Cross-sectional study was conducted on 34 pregnant women divided into three groups: normotensive (n = 12), early-onset (n = 11), and the late-onset (n = 11). Subjects were patient from ER and inpatient unit of the Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University/Dr Mohammad Hoesin Hospital, Palembang, during April–June 2015. Results: CO values of the early onset group was lower (3.4 + 0.27, p < 0.001) with higher SVR (3100.2 + 261.3, p < 0.001) than the other two groups. SVR in preeclamptic group was higher compared to the control, the early onset presenting higher SVR than the late-onset group (3100.2 + 261.3 vs 2217.1 + 407.8, p < 0.001). Cardiac index variables between groups were also different, except in the early onset group and controls (p = 0.045). In blood pressure and MAP variable, we only noticed difference between the early onset group and control (p < 0.001) as well as late-onset group and controls (p < 0.001). LVMi, LVID and LVPWT in control group was lower than the others (p < 0.001; p = 0.049; p = 0.009), but were similar for the early onset and late-onset groups [98.7 (86.5–203) vs 132 (77.7–17.6); 4.7 (0.4) vs 4.8 (0.5); 1.1 (0.7–1.3) vs 1.1 (0.8–1.6)]. RWT was relatively similar across the three arms of the study (p = 0.264). Conclusion: In severe preeclampsia, there are changes in hemodynamic, ventricular morphometry, and left ventricular function, which is more evident in the group of early-onset preeclampsia than late-onset preeclampsia.

  1. Eiland E, Nzerue C, et al. Preeclampsia 2012. J pregnancy 2012;2012: 1–7.
  2. Sibai BM. Maternal and Uteroplacental hemodynamics for the classification and prediction of preeclampsia. Hypertension 2008;52(5):805–806. DOI: 10.1161/HYPERTENSIONAHA.108.119115.
  3. Tomsin K, Mesens T, et al. Characteristics of heart, arteries, and veins in low and high cardiac output preeclampsia. Eur J Obstet Gynecol Reprod Biol 2013;169(2):218–222. DOI: 10.1016/j.ejogrb.2013.03.016.
  4. Oana S, Ruxandra J, et al. Morphological and functional adaptation of the maternal heart during pregnancy. Circulation: Cardiovascular Imaging 2012;5:289–297. DOI: 10.1161/CIRCIMAGING.111.970012.
  5. Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol 2012;36(1):56–59. DOI: 10.1053/j.semperi.2011.09.011.
  6. Murphy DJ. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy 2000;19:221–231. DOI: 10.1081/PRG-100100138.
  7. Ness RM, Sibai BM. Sgared and disparate components of the pathophysiologics of fetal growth restriction and preeclampsia. Am J Obstet Gynecol 2006;2006(195):40–49. DOI: 10.1016/j.ajog.2005.07.049.
  8. Easterling TR, Benedetti TJ, et al. Maternal hemodynamics in normal and preeclamtic pregnancies: a longitudinal study. Obstet Gynecol 1990;76:1061–1069.
  9. Valensise H, Vasapollo B, et al. Early and late preeclampsia: two different maternal hemodynamic states in the latent phase of the disease. Hypertension 2008;52(5):873–880. DOI: 10.1161/HYPERTENSIONAHA.108.117358.
  10. DuBois D, DuBois EF. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916;17:863–871. DOI: 10.1001/archinte.1916.00080130010002.
  11. Normal hemodynamic parameters. Diunduh dari: http:/www/ hemodynamic parameters.
  12. Bosio PM, McKenna PJ, et al. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol 1999;94: 978–984. DOI: 10.1097/00006250-199912000-00014.
  13. Carolyn Y, Solomon SD. A Clinician's guide to tissue doppler imaging. Circulation 2006;113:396–398.
  14. Dennis AT, Castro J, et al. Haemodynamics in women with untreated preeclampsia. Anaesthesia 2012;67:1105–1118. DOI: 10.1111/j.1365-2044.2012.07193.x.
  15. Huppertz B. Placental Origins of Preeclampsia Challenging the Current Hypothesis. Hypertension 2008;51:970–975. DOI: 10.1161/HYPERTENSIONAHA.107.107607.
  16. Cnossen JS, Morris RK, et al. Use of uterine artery Doppler ultrasonography to predict preeclampsia and intrauterine growth restriction: a systemic review and bivariable meta analysis. CMAJ 2008;178(6):701–711. DOI: 10.1503/cmaj.070430.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.