Maternal cardiac function in fetal growth‐restricted and non‐growth‐restricted small‐for‐gestational age pregnancies

Abstract

Objective To compare maternal cardiac function in women with intrauterine growth restriction (IUGR) to those with small-for-gestational age (SGA) pregnancies (non-IUGR). Methods This was a cross-sectional study involving maternal echocardiography and uterine, umbilical and fetal middle cerebral artery Doppler assessment in 52 normotensive women at 20-36 weeks' gestation with SGA fetuses (26 IUGR and 26 non-IUGR). Results In the IUGR (compared to the non-IUGR) group

Relationship Between Prepregnancy and Early Pregnancy Uterine Blood Flow and Resistance Index

“…Further, our preliminary findings indicate a tendency for lower prepregnancy CO in the preeclamptic subgroup and a significantly lower CO within this group during early pregnancy as compared to the women who did not develop preeclampsia. This observation is consistent with studies suggesting that women who develop preeclampsia have lower CO than those with normal pregnancies 31, 32. However, we recognize that due to very small sample size, our observations within the preeclamptic subgroup are not conclusive, rather, hypothesis-generating, and may suggest an existing maternal phenotype that may predispose women to preeclampsia.…”

Maternal Cardiovascular Impairment in Pregnancies Complicated by Severe Fetal Growth Restriction

“…16 Multiple regression analysis in our cohort of normotensive FGR pregnancies suggested that global diastolic dysfunction was related to both a higher afterload, as demonstrated by the increased mean arterial pressure and maternal increased body mass index. Several mechanisms evident in high body mass index individuals could influence maternal cardiac function, including inflammation, endothelial dysfunction, thrombotic tendency, and LV hypertrophy attributed to an increased blood volume.…”

“…11,12 Despite these cardiovascular findings in PE, previous studies of maternal cardiac function in FGR pregnancy failed to identify a clear pattern of myocardial impairment or chamber dysfunction. [13][14][15][16] This is possibly due to the inadequacy of the load-dependent indices used and the interpretation of diastolic measures in isolation, disregarding the interdependency of cardiac events. The aim of this study was to test the hypothesis that women with normotensive FGR pregnancies also exhibit cardiac remodeling and myocardial and ventricular dysfunction, as seen in PE pregnancies using established diagnostic algorithms integrating conventional echocardiographic and tissue Doppler indices.…”

Perinatal Changes of Circulating N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) in Normal and Intrauterine-Growth-Restricted Pregnancies

“…Nevertheless, our finding could be explained by the fact that, in hypertensive pregnant women, uteroplacental blood flow impairement (31) results in reduced maternal plasma volume expansion (32) and subsequently to lack of increase in left ventricular end-diastolic dimensions (33) and probably NTproBNP production. Moreover, pregnant women with IUGR offspring were found to have a significantly lower left ventricular mass and end-diastolic dimension (34,35), thus failing to demonstrate the physiological myocardial hypertrophy observed in normal pregnancies (36,37), which leads to increased NT-proBNP production, compared to nonpregnant women (38).…”