The changes in maternal hemodynamic features as prediction of preeclampsia

Abstract

Despite a significant volume of literature regarding placental dysfunction in PE, data regarding the cardiac changes associated with PE are more scant, and also more controversial. The conventional belief was that early PE is associated with reduced cardiac output and increased total vascular resistance, with maternal cardiac function succumbing early in the disease process. Objective: To evaluate the predictive values of the circulatory syndromes in preclinical possibilities development of PE. Investigations of the circulatory syndromes of CVS and hemodynamic supporting of pregnancy was carried out in the first trimester in 114 women with physiological pregnancy (PP) and in 132 pregnant women who had preeclamplasia (WWP) in the II and III trimesters. The control group consisted of 137 healthy non-pregnant women. The comprehensive registration of main parameters of the central and peripheral hemodynamics was conducted through the standard method of rheography. We determined of circulatory syndromes by correlation of minute volume of blood while standing/lying – I type (hypokinetic condition) and III type (hyperkinetic condition) of hemodynamics. The hemodynamic risk was determined in accordance with the index of hemodynamic nonoptimality. WWP there were a significant (p <0.01) decrease in the proportion of optimal states with type I and a significant (p <0.01) increase in states with type III of the circulatory state of the CVS. This type was associated with a suboptimal and strained state of hemodynamics in the regime of antigravitational supply of blood circulation in the basic postural conditions of a person's life activity creature (standing, sitting, walking) and pregnant with minimizing restorative capacities in a lying position. According to our investigations the optimization of hemodynamical supporting in PP was mechanism of vasodilator "slippage" of arterial vessels from the systemic vasoconstriction as the hemodynamic equivalent of endothelial activity. The predictors of PE in pregnant women were hyperkinetic type of circulation, integral indicators of functional depreciation of the circulatory syndromes of CVS - hemodynamic risk, circulatory syndromes of arterial or venous blood insufficiency in abdominal and pelvic regions. Our results obtained that the predictors of PE were hemodynamic syndromes of insufficiency and circulatory limitation from the I-st trimester.