Pre-eclampsia outcomes in different hemodynamic models
Article first published online: 15 APR 2008
© 2007 The Authors. Journal compilation © 2007 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 34, Issue 2, pages 179–188, April 2008
How to Cite
Mei, S., Gu, H., Wang, Q., Zhang, S. and Zeng, Y. (2008), Pre-eclampsia outcomes in different hemodynamic models. Journal of Obstetrics and Gynaecology Research, 34: 179–188. doi: 10.1111/j.1447-0756.2007.00687.x
- Issue published online: 15 APR 2008
- Article first published online: 15 APR 2008
- Received: January 11 2007.Accepted: August 23 2007.
- maternal outcome;
- neonatal morbidity;
- neonatal mortality;
Aim: To evaluate whether there is a significant relationship between hemodynamic models and pre-eclampsia outcomes.
Method: A controlled experimental study was performed. We analyzed 2910 hemodynamic series systematically sampled from 970 pregnant women three times every 2 weeks from the definite diagnosis of pre-eclampsia until delivery. Women were divided into three groups based on total peripheral resistance (TPR): a low-TPR group, a normal-TPR group and a high-TPR group. Every group was divided into three subgroups based on cardiac index (CI): a low-CI subgroup, a normal-CI group and high-CI group. Common lab tests, electrocardiographic examination, fundus examination, cardiac function, liver function and kidney function were measured after every hemodynamic monitoring. Primary outcomes included various maternal and neonatal morbidity and neonatal and infant mortality.
Results: In our study we found seven hemodynamic models in pre-eclampsia during the third trimester of pregnancy. No significant differences in maternal age, weight, and height were observed between the three groups. The low-TPR and normal-TPR groups showed better disease results than the high-TPR group in respect of HELLP (P < 0.01), lung edema (P < 0.01), acute renal failure (P < 0.01), heart failure (P < 0.01), neonatal intensive care unit admission (P < 0.01), infant weight (P < 0.01), neonatal mortality (P < 0.01) and infant mortality (P < 0.01). The low-TPR group had better results than the normal-TPR group in respect of eclampsia (P < 0.01), liver hemorrhage (P < 0.01), birthweight (P < 0.01) and gestational week at birth (P < 0.05).
Conclusion: Among all the subgroups, the highest maternal and neonatal morbidity was in the high-TPR-high-CI subgroup. There is clear relationship between hemodynamic and disease outcomes during the third trimester.