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Reproductive Sciences
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Article

Cardiac Adaptation to Pregnancy in Women With a History of Preeclampsia and a Subnormal Plasma Volume

Silvia Andrietti, Arnold-Jan Kruse*, Sebastiaan Bekkers, Simone Sep, Marc Spaanderman, and Louis Peeters

* To whom correspondence should be addressed. E-mail: arnoldjankruse{at}hotmail.com.


  Abstract
In former preeclamptics, a subnormal plasma volume (LPV) predisposes to hemodynamic maladaptation to pregnancy. Here, we assessed the initial cardiovascular response to pregnancy in LPV (n = 20), in former preeclamptics with normal plasma volume (NPV) (n = 35) and in parous controls (CONTR) (n = 9) by echocardiography, blood pressure and heart rate (HR), before pregnancy, and by 5 and 7 weeks amenorrhea. Data analysis was by nonparametric tests. LPV differed from NPV and CONTR, by a consistently lower E/A ratio (ratio of peak mitral flow velocity in early diastole [E] and that during atrial contraction [A]) and an early-pregnancy rise in left atrial diameter (LAD). Both NPV and LPV differed from CONTR by an early-pregnancy rise in HR. The consistently lower E/A ratio together with the early-pregnancy LAD rise in LPV indicate diastolic dysfunction. The early-pregnancy rise in HR suggests sympathetic dominance in the autonomic control of the circulation.

First published on October 20, 2008, doi:10.1177/1933719108322427

Reproductive Sciences 2008;15:1059.

A more recent version of this article appeared on December 1, 2008

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