Maternal cardiac function in normotensive and pre-eclamptic intrauterine growth restriction

Objectives To compare maternal cardiac function between pregnancies complicated by normotensive and pre-eclamptic intrauterine growth restriction (IUGR). Methods Two-dimensional Doppler echocardiography and Doppler tissue imaging (DTI) were used to examine 19 pregnant women with IUGR and 17 with preeclampsia complicated by IUGR at 20-38 weeks of gestation. Indices were converted into differences tit SDs front the expected normal mean for gestation (Z-scores) and compared. Results With respect to normal pregnancy, in the normotensive IUGR compared with the pre-eclamptic IUGR group, there were similar reductions in maternal cardiac output (Z-score, -1.71 vs. -1.37, P = 0.26) and heart rate (Z-score, -3.67 vs. -9.43, P = 0.1) and a similar increase tit total vascular resistance (Z-score, 2.91 vs. 3.93, P = 0.05). There was also a greater decrease tit stroke volume (Z-score, -1.72 us. -0.69, P = 0.01), a smaller increase in mean arterial pressure (Z-score, 0.73 vs. 2.94, P < 0.01) and a smaller decrease tit DTI systolic velocity at the lateral mitral margin (Z-score, -0.4 vs. -1.42, P = 0.02). In terms of diastolic function, there was a smaller transmitral late diastolic velocity (Z-score, 0.04 vs. 0.93, P = 0.0.3) and a greater DTI early diastolic velocity at the lateral mitral margin (Z-score, -0.17 vs. -1.6, P < 0.01). Conclusions In normotensive IUGR and pre-eclamptic IUGR there is a similar alteration in maternal left ventricular systolic function, but there is greater impairment tit maternal diastolic function tit pre-eclamptic IUGR. Copyright (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.