182. Dye-densitometry analysis of maternal circulating blood volume and cardiac output in hypertensive disorder in pregnancy

Abstract

In hypertensive disorder in pregnancy (HDP), blood pressure increases due to vasospasm caused by vascular endothelial cells disorders. Simultaneously, vascular permeability increases, therefore result in decrease and concentration in circulating blood volume. DDG analyzer is a method which enables us to calculate cardiac output, circulating blood volume (CBV), and other indicators simultaneously, non-invasively and continuously. Several serum biomarkers are reported as indicators of early detection of HDP. However, there is no report to show correlation with serum biomarkers and CBV of HDP. We identified serum biomarkers which correlate with CBV measured percutaneously. We assigned 120 women with singleton pregnancies who underwent Caesarean section during March 2000–April 2007 at Saitama Medical University. According to pregnancy induced pregnancy (PIH) criteria of Japanese Society of Obstetrics and Gynaecology 2005, patients are enrolled in three groups: normal(NP, n = 60), gestational hypertension(GH, n = 12), and preeclampsia(PE, n = 48). CBV and cardiac output are measured just before the operation with DDG-2001(Nihon Koden, Japan). Tukey–Kramer method or Steel–Dwass method are used to calculate significant difference between three groups, and Spearman’s correlation coefficient is used to identify correlation. CBV is significantly low in PE subjects compared to NP subjects, but there is no significant difference in cardiac output. Negative correlation between biomarkers and CBV are as follows: in NP subjects, BUN, AST, and ALT. In GH subjects, Hct. In PE subjects, UA, BUN, and ALT. In our study, DDG analyzer revealed CBV is significantly low in PE subjects compared to NP subjects. There is a possibility that CBV has correlation with severity of HDP. We identified UA, BUN, and especially Hct reflect decrease of CBV. To evaluate severity of HDP and consider timing of termination, blood pressure and proteinuria are important indicators, but with these biomarkers safer labour management could be possible.