The effect of impedance cardiography directed antihypertensive therapy on fetal growth restriction rates and perinatal mortality in women with chronic hypertension

Cottrell, Jesse; Cummings, Kelly; Jude, David C.; Chaffin, David G.

doi:10.1016/j.preghy.2022.03.006

Cited by 1 publication

(2 citation statements)

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“…12 Studies of maternal haemodynamics in women suffering from HDP on antihypertensive treatment indicate effectiveness of haemodynamically guided antihypertensive therapy. 13 The data to support this, however, are limited. Khalil et al demonstrated significantly lower arterial stiffness in women treated with alpha-methyldopa, the first-line treatment of hypertension in pregnancy 14 in many countries.…”

Section: Open Accessmentioning

confidence: 99%

“…Furthermore, there is no international consensus on when and how increased blood pressure in pregnancy should be treated 12. Studies of maternal haemodynamics in women suffering from HDP on antihypertensive treatment indicate effectiveness of haemodynamically guided antihypertensive therapy 13. The data to support this, however, are limited.…”

Section: Introductionmentioning

confidence: 99%

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Maternal haemodynamics in Hypertensive Disorders of Pregnancy under antihypertensive therapy (HyperDiP): study protocol for a prospective observational case–control study

et al. 2023

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IntroductionHypertensive disorders of pregnancy (HDP) are associated with a high incidence of maternal and perinatal morbidity and mortality. HDP, in particular pre-eclampsia, have been determined as risk factors for future cardiovascular disease. Recently, the common hypothesis of pre-eclampsia being a placental disorder was challenged as numerous studies show evidence for short-term and long-term cardiovascular changes in pregnancies affected by HDP, suggesting a cardiovascular origin of the disease. Despite new insights into the pathophysiology of HDP, concepts of therapy remain unchanged and evidence for improved maternal and neonatal outcome by using antihypertensive agents is lacking.Methods and analysisA prospective observational case–control study, including 100 women with HDP and 100 healthy controls, which will assess maternal haemodynamics using the USCOM 1A Monitor and Arteriograph along with cardiovascular markers (soluble fms-like kinase 1/placental-like growth factor, N-terminal pro-B type natriuretic peptide) in women with HDP under antihypertensive therapy, including a follow-up at 3 months and 1 year post partum, will be conducted over a 50-month period in Vienna. A prospective, longitudinal study of cardiovascular surrogate markers conducted in Oslo will serve as a comparative cohort for the Vienna cohort of haemodynamic parameters in pregnancy including a longer follow-up period of up to 3 years post partum. Each site will provide a dataset of a patient group and a control group and will be assessed for the outcome categories USCOM 1A measurements, Arteriograph measurements and Angiogenic marker measurements. To estimate the effect of antihypertensive therapy on outcome parameters, ORs with 95% CIs will be computed. Longitudinal changes of outcome parameters will be compared between normotensive and hypertensive pregnancies using mixed-effects models.Ethics and disseminationEthical approval has been granted to all participating centres. Results will be published in international peer-reviewed journals and will be presented at national and international conferences.

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Section: Open Accessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%