SYDNEY, AUSTRALIA – Women at high risk of early preeclampsia who show signs of abnormal hemodynamic function earlier in pregnancy may be more likely to have adverse pregnancy outcomes, new data suggest.
A prospective cohort study in 36 women at high risk for early preeclampsia (at less than 34 weeks’ gestation) showed that those who experienced adverse outcomes had significantly higher total peripheral resistance at 14 weeks (1,710 vs. 1,307 dyne/sec/cm–5, P = .02), 24 weeks (1,564 vs. 1,305 dyne/sec/cm–5, P less than .001), and 30 weeks (1,603 vs. 1,323 dyne/sec/cm–5, P = .002) of gestation, compared with high-risk women who had normal outcomes.
Ms. Kate Russo
According to data presented at the International Society of Ultrasound in Obstetrics and Gynecology world congress, cardiac output also was significantly lower at 14 weeks (4.41 vs. 5.18 L/min, P = .04) and 30 weeks (4.79 vs. 5.36 L/min, P = .04) of gestation in women who experienced adverse outcomes.
The results suggest that women at high risk for early preeclampsia and a subsequent adverse pregnancy outcome show signs of abnormal cardiac function as early as 14 weeks’ gestation, the researchers said.
Researcher Kate Russo said the results could help to differentiate between those who are likely to have a normal outcome and those who may develop an adverse outcome, in women who have already been identified as high risk through preeclampsia screening.
"We want to reduce the 10% false-positive rate of this screening, which has a 90% detection rate for early-onset preeclampsia," said Ms. Russo, a sonographer and Ph.D. candidate in the fetal medicine unit at the Royal Prince Alfred Hospital in Sydney.
"Performing a maternal echocardiogram in high-risk women is an easy, well-tolerated examination that can be utilized for the assessment of the women’s hemodynamic profile," she said.
The adverse outcomes, observed in 15 (42%) of the women enrolled in the study, included preeclampsia (11%), gestational hypertension (14%), low birth weight (14%), and preterm birth (3%).
Being able to identify women who were at greater risk of adverse pregnancy outcomes might help reduce the anxiety of some women deemed at high risk of early preeclampsia, as well as guide treatment, Ms. Russo said in an interview.
"You know who to look at, and potentially, if women develop hypertension, you can target their antihypertensive medication depending on their hemodynamic profile," she said.
The study is continuing to recruit participants, with the aim of comparing the hemodynamic profiles of women with early-onset preeclampsia, late-onset preeclampsia, and small-for-gestational-age babies.
No conflicts of interest were declared.