Objective: We aimed to compare the haemodynamic profiles of obese and non-obese pregnant women, alongside describing the haemodynamic changes that occur in hypertensive disorders of pregnancies with an Appropriate for Gestational Age Fetus (HDP-AGA) beyond 34 weeks’ gestation. Study design: In this prospective case-control study, maternal haemodynamic assessment was carried out by a trained operator using an UltraSonic Cardiac Output Monitor during a routine clinical assessment after 34 weeks of gestation. Indexed and non-indexed parameters were evaluated. Main outcome measures: Maternal hemodynamic parameters. Results: Obese and non-obese women did not differ for non-indexed parameters (Cardiac Output, Stroke Volume, Systemic Vascular Resistance). Using indexed parameters, corrected for Body Surface Area, obese women presented significantly lower Cardiac Index z-score (−0.23 ± 0.5 vs 0.26 ± 1.2; p = 0.004), Stroke Volume Index z-score (−0.27 ± 0.8 vs 0.31 ± 1.0; p < 0.0001) and significantly higher Systemic Vascular Resistance Index (0.16 ± 0.8 vs −0.36 ± 0.7; p < 0.0001). In obese women, HDP-AGA (n = 19) had significantly higher Systemic Vascular Resistance Index z-score (1.26 ± 1.7 vs 0.16 ± 0.8; P = 0.009) and significantly lower Stroke Volume Index (−0.68 ± 0.8 vs −0.27 ± 0.8; 0.049). Conclusion: Using indexed parameters, differences in haemodynamic profiles between obese and non obese women can be highlighted. Obese women seem to present a cardiac maladapation to the pregnancy (reduced cardiac index and stroke volume and increased vascular resistance) that could explain the increased risk of complications in this subgroup.

The impact of obesity on haemodynamic profiles of pregnant women beyond 34 weeks’ gestation / Sarno, L.; Morlando, M.; Giudicepietro, A.; Carlea, A.; Sidhu, S.; Campanile, M.; Maruotti, G. M.; Martinelli, P.; Guida, M.. - In: PREGNANCY HYPERTENSION. - ISSN 2210-7789. - 22:(2020), pp. 191-195. [10.1016/j.preghy.2020.10.001]

The impact of obesity on haemodynamic profiles of pregnant women beyond 34 weeks’ gestation

Sarno L.
;
Morlando M.;Giudicepietro A.;Carlea A.;Campanile M.;Maruotti G. M.;Martinelli P.;Guida M.
2020

Abstract

Objective: We aimed to compare the haemodynamic profiles of obese and non-obese pregnant women, alongside describing the haemodynamic changes that occur in hypertensive disorders of pregnancies with an Appropriate for Gestational Age Fetus (HDP-AGA) beyond 34 weeks’ gestation. Study design: In this prospective case-control study, maternal haemodynamic assessment was carried out by a trained operator using an UltraSonic Cardiac Output Monitor during a routine clinical assessment after 34 weeks of gestation. Indexed and non-indexed parameters were evaluated. Main outcome measures: Maternal hemodynamic parameters. Results: Obese and non-obese women did not differ for non-indexed parameters (Cardiac Output, Stroke Volume, Systemic Vascular Resistance). Using indexed parameters, corrected for Body Surface Area, obese women presented significantly lower Cardiac Index z-score (−0.23 ± 0.5 vs 0.26 ± 1.2; p = 0.004), Stroke Volume Index z-score (−0.27 ± 0.8 vs 0.31 ± 1.0; p < 0.0001) and significantly higher Systemic Vascular Resistance Index (0.16 ± 0.8 vs −0.36 ± 0.7; p < 0.0001). In obese women, HDP-AGA (n = 19) had significantly higher Systemic Vascular Resistance Index z-score (1.26 ± 1.7 vs 0.16 ± 0.8; P = 0.009) and significantly lower Stroke Volume Index (−0.68 ± 0.8 vs −0.27 ± 0.8; 0.049). Conclusion: Using indexed parameters, differences in haemodynamic profiles between obese and non obese women can be highlighted. Obese women seem to present a cardiac maladapation to the pregnancy (reduced cardiac index and stroke volume and increased vascular resistance) that could explain the increased risk of complications in this subgroup.
2020
The impact of obesity on haemodynamic profiles of pregnant women beyond 34 weeks’ gestation / Sarno, L.; Morlando, M.; Giudicepietro, A.; Carlea, A.; Sidhu, S.; Campanile, M.; Maruotti, G. M.; Martinelli, P.; Guida, M.. - In: PREGNANCY HYPERTENSION. - ISSN 2210-7789. - 22:(2020), pp. 191-195. [10.1016/j.preghy.2020.10.001]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/820238
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