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Maternal cardiac twist pre-pregnancy: Potential as a novel marker of pre-eclampsia

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journal contribution
posted on 06.05.2022, 14:46 by Victoria L. Meah, John Cockcroft, Eric StohrEric Stohr

 Healthy pregnancy is characterised by progressive physiological adaptation of the maternal cardiovascular (CV) system that facilitates optimal fetal development. The adaptations that constitute a healthy or normal progression are not always evident, and, in particular, CV adaptation to pregnancy is highly individualised. Some women develop pregnancy-related CV dysfunction such as pre-eclampsia (PE). Typically, PE is diagnosed by the development of hypertension and proteinuria after 20 weeks of pregnancy and is the leading cause of maternal and perinatal mortality and morbidity. Despite continued efforts to improve the understanding of the aetiology, pathophysiology and subsequently treatment for the disease, CV changes in PE are not well understood. PE before 34 weeks (early onset PE) is believed to differ in pathogenesis from late onset PE (>34 weeks) and can be characterised by a haemodynamic profile of increased systemic vascular resistance (SVR) and lower cardiac output (CO). Early onset PE is more often associated with uteroplacental insufficiency and significant adverse maternal and perinatal outcomes. In contrast, late onset PE (>34 weeks) involves an increased CO and lower SVR and is less likely to be associated with uteroplacental insufficiency and adverse perinatal outcomes. It is not known if PE develops secondary to the CV maladaptation in pregnancy or if a preexisting CV dysfunction predisposes some women to develop PE. Screening, diagnosis and disease management would be vastly improved if more were known about the onset of the maladaptive process associated with PE. To date, a combination of maternal factors including medical history, body mass index, age, parity and blood pressure (BP) have been used to predict the development of PE. In the first trimester, arterial stiffness is significantly increased in women who develop PE. Current hypotheses speculate that CV dysfunction is evident very early in pregnancy in PE and precedes the clinical manifestation at a later stage but whether CV dysfunction is present before pregnancy remains to be elucidated. 

History

Published in

Fetal and Maternal Medicine Review

Publisher

Cambridge University Press

Version

AM (Accepted Manuscript)

Citation

Meah, V.L., Cockcroft, J.R. and Stöhr, E.J., (2013) 'Maternal cardiac twist pre-pregnancy: potential as a novel marker of pre-eclampsia', Fetal and Maternal Medicine Review, 24(04), pp.289-295

Print ISSN

0965-5395

Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

John Cockcroft Eric Stohr

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

Copyright Holder

© The Publisher

Language

en