Gutierrez Henares, J; Gutierrez Henares, R; Perry, H; Khalil, A; Thilaganathan, B
(2022)
Maternal cardiovascular potential and kinetic energy indices in pre-eclamptic and small-for-gestational-age pregnancies.
Ultrasound Obstet Gynecol, 59 (5).
pp. 613-618.
ISSN 1469-0705
https://doi.org/10.1002/uog.24768
SGUL Authors: Thilaganathan, Baskaran
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Abstract
Objective
Non-invasive assessment of maternal cardiovascular potential and kinetic energy can be used to derive potential-to-kinetic-energy ratio (PKR) and Smith–Madigan inotropic index (SMII), which reflect the balance between blood pressure and blood flow. The aim of this study was to evaluate PKR and SMII in pregnancies complicated by hypertensive disorders of pregnancy (HDP) and/or small-for-gestational-age (SGA) birth.
Methods
This was a prospective study that enrolled women with a singleton pregnancy between 5 and 41 weeks' gestation. Women who developed HDP and/or SGA underwent cardiovascular profiling from 20 weeks. To establish reference ranges for PKR and SMII, women without any pre-existing medical problems at the time of booking who did not develop HDP, SGA or other complications during pregnancy were also recruited for cardiovascular profiling. Measurements of cardiovascular parameters were obtained using a non-imaging ultrasound cardiac output monitor.
Results
A total of 688 women completed the study, including 626 controls, 21 cases with HDP, 19 cases with SGA and 22 cases with HDP and SGA. PKR was significantly elevated in pregnancies with placental dysfunction compared with controls (HDP only, 29.81 ± 9.5; HDP and SGA, 44.33 ± 24.27; SGA only, 31.05 ± 13.14; vs controls, 22.30 ± 7.93; all P < 0.05). SMII values were significantly lower only in cases affected by SGA alone when compared with controls (1.47 ± 0.23 W/m2 vs 1.75 ± 0.40 W/m2; P < 0.005). These differences remained statistically significant when the analysis was undertaken using multiples of the median values corrected for gestational age.
Conclusions
The findings of this study suggest that point-of-care non-invasive cardiovascular profiling using PKR and SMII may help distinguish between pregnancies affected by specific placental disorders and those exhibiting healthy cardiovascular adaptation to pregnancy. Women with HDP and/or SGA appear to have distinctive PKR and SMII profiles that reflect low kinetic energy in pregnancies with SGA and high potential energy in pregnancies affected by HDP. Finally, non-invasive assessment of potential and kinetic cardiovascular energy demonstrates physiological high-flow and low-resistance adaptation in uncomplicated pregnancies.
Item Type: |
Article
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Additional Information: |
This is the peer reviewed version of the following article: Gutierrez Henares, J., Gutierrez Henares, R., Perry, H., Khalil, A. and Thilaganathan, B. (2022), Maternal cardiovascular potential and kinetic energy indices in pre-eclamptic and small-for-gestational-age pregnancies. Ultrasound Obstet Gynecol, 59: 613-618, which has been published in final form at https://doi.org/10.1002/uog.24768. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Keywords: |
Haemodynamics, Kinetic energy, Potential energy, Pregnancy, SMII PKR, USCOM, fetal growth restriction, hypertension, pre-eclampsia, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
Ultrasound Obstet Gynecol |
ISSN: |
1469-0705 |
Language: |
eng |
Dates: |
Date | Event |
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1 May 2022 | Published | 16 September 2021 | Published Online | 31 August 2021 | Accepted |
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Publisher License: |
Publisher's own licence |
PubMed ID: |
34529288 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/113692 |
Publisher's version: |
https://doi.org/10.1002/uog.24768 |
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