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P36. Association of aortic stiffness with uterine artery Doppler pulsatility index and risk of preeclampsia
Poster Presentations / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 1 (2011) 273–299
weight (p = 0.004) and gestational age at delivery (p << 0.05). Conclusions: As expected, the incidence of hypertensive disorders in pregnancies complicated by type 1 diabetes is higher than in general population. In addition, in our group of study, a poor pregnancy outcome was observed in pregnancies complicated by hypertensive disorders. None statistically significant difference ws observed between the group treated with insulin pump and the group treated with multiinjective insulin therapy. doi:10.1016/j.preghy.2011.08.096
CARDIOVASCULAR FUNCTION
P37. Association of aortic stiffness with uterine artery Doppler pulsatility index and risk of preeclampsia Thomas R. Everett a, Amita A. Mahendru a, Ian B. Wilkinson b, Christoph C. Lees a (a Dept. of Fetal Medicine, Box 228, Addenbrooke’s Hospital, Cambridge, United Kingdom, b Clinical Pharmacology, Addenbrooke’s Hospital, Cambridge, United Kingdom) Objective: Carotid-femoral wave velocity (cfPWV) is increased in women with preeclampsia. Assessment of spiral artery transformation and successful placentation by uterine artery Doppler pulsatility index (UtAD PI) in the second trimester is a widely used screening tool for early-onset preeclampsia and fetal growth restrinction. We sought to determinate whether there was a relationship between uterine artery Doppler impedance and maternal aortc stiffness. Methods: 92 consecutive women were recruited from the high risk obstetric ultrasound clinic in the second trimester. Median age 32.8 years (range: 19–45 years), median gestation 23 + 6 weeks (range 19 + 6 26 + 1). Smokers were excluded. Transabdominal Doppler measurements of the
289
uterine arteries were performed using Siemens Acuson S2000 ultrasound machine and a mean pulsatility index calculated. A Vicorder (Bristol, UK) device was used to measure cfPWV. Prior to cfPWV measurement, women were rested supine for 10 min in 30° left lateral position. Three consistent readings were performed and a mean value calculated. cfPWV was adjusted for mean arterial pressure using univariate analysis using SPSS software v18.0. Results: There was significant positive association between uterine artery Doppler pulsatility index and increasing maternal aortic stiffness (r = 0.23, P = 0.03). Conclusions: In the late second trimester of pregnancy, increasing UtAD PI reflects impaired placentation and increasing risk of preeclampsia. We show that women at increasing risk of preeclampsia have higher aortic stiffness, even if in the absence of preeclampsia. Further studies are required to determinate whether this is a reflection of abnormal placentation on aortic stiffness, or whether the increased aortic stiffness precedes pregnancy. First Author <35 years: yes. doi:10.1016/j.preghy.2011.08.097
P38. Non-invasive haemodynamic monitoring using transthoracic echocardiography in pregnancy: Validation against cardiac catheterisation Jerome Cornette a,b, Hennie lombaard a, Jolien Roos c, Wim Hop d, Robert C. Pattinson a (a Department of Obstetrics and Gynaecology, Kalafong Hospital, University of Pretoria, South Africa, b Department of Obstetrics Gynecology, Division of Obstetrics & Prenatal Medicine, The Netherlands, c Department of Cardiology, The Netherlands, d Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands) Objective: Haemodynamic monitoring can be valuable in severe pre-eclampsia and critically ill obstetric women.
weight (p = 0.004) and gestational age at delivery (p << 0.05). Conclusions: As expected, the incidence of hypertensive disorders in pregnancies complicated by type 1 diabetes is higher than in general population. In addition, in our group of study, a poor pregnancy outcome was observed in pregnancies complicated by hypertensive disorders. None statistically significant difference ws observed between the group treated with insulin pump and the group treated with multiinjective insulin therapy. doi:10.1016/j.preghy.2011.08.096
CARDIOVASCULAR FUNCTION
P37. Association of aortic stiffness with uterine artery Doppler pulsatility index and risk of preeclampsia Thomas R. Everett a, Amita A. Mahendru a, Ian B. Wilkinson b, Christoph C. Lees a (a Dept. of Fetal Medicine, Box 228, Addenbrooke’s Hospital, Cambridge, United Kingdom, b Clinical Pharmacology, Addenbrooke’s Hospital, Cambridge, United Kingdom) Objective: Carotid-femoral wave velocity (cfPWV) is increased in women with preeclampsia. Assessment of spiral artery transformation and successful placentation by uterine artery Doppler pulsatility index (UtAD PI) in the second trimester is a widely used screening tool for early-onset preeclampsia and fetal growth restrinction. We sought to determinate whether there was a relationship between uterine artery Doppler impedance and maternal aortc stiffness. Methods: 92 consecutive women were recruited from the high risk obstetric ultrasound clinic in the second trimester. Median age 32.8 years (range: 19–45 years), median gestation 23 + 6 weeks (range 19 + 6 26 + 1). Smokers were excluded. Transabdominal Doppler measurements of the
289
uterine arteries were performed using Siemens Acuson S2000 ultrasound machine and a mean pulsatility index calculated. A Vicorder (Bristol, UK) device was used to measure cfPWV. Prior to cfPWV measurement, women were rested supine for 10 min in 30° left lateral position. Three consistent readings were performed and a mean value calculated. cfPWV was adjusted for mean arterial pressure using univariate analysis using SPSS software v18.0. Results: There was significant positive association between uterine artery Doppler pulsatility index and increasing maternal aortic stiffness (r = 0.23, P = 0.03). Conclusions: In the late second trimester of pregnancy, increasing UtAD PI reflects impaired placentation and increasing risk of preeclampsia. We show that women at increasing risk of preeclampsia have higher aortic stiffness, even if in the absence of preeclampsia. Further studies are required to determinate whether this is a reflection of abnormal placentation on aortic stiffness, or whether the increased aortic stiffness precedes pregnancy. First Author <35 years: yes. doi:10.1016/j.preghy.2011.08.097
P38. Non-invasive haemodynamic monitoring using transthoracic echocardiography in pregnancy: Validation against cardiac catheterisation Jerome Cornette a,b, Hennie lombaard a, Jolien Roos c, Wim Hop d, Robert C. Pattinson a (a Department of Obstetrics and Gynaecology, Kalafong Hospital, University of Pretoria, South Africa, b Department of Obstetrics Gynecology, Division of Obstetrics & Prenatal Medicine, The Netherlands, c Department of Cardiology, The Netherlands, d Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands) Objective: Haemodynamic monitoring can be valuable in severe pre-eclampsia and critically ill obstetric women.