585: Noninvasive measurement of hemodynamic and autonomous nervous system parameters throughout normal and complicated pregnancy

Abstract

To evaluate non-invasive measurement of hemodynamic (HD) and autonomous nervous system (ANS) parameters in pregnancy. In 20 healthy pregnant women (HP), 5 pregnant women with preexisting cardiovascular diseases (PD), and 8 women with preeclampsia (PE) assessment of HD and ANS was performed using the Task Force Monitor® 3040i system (TFM). Under standardized conditions, at 4 different time points throughout pregnancy (HP and PD) or at onset of disease (PE > 30 wks) the following parameters were evaluated: heart rate (HR), blood pressure (BP), total peripheral resistance (TPR), stroke volume (SV), stroke index (SI), cardiac output (CO), contractility index (CI), acceleration index (ACI), blood pressure variability (BPV), and baroreceptorsensitivity (BRS). The deep breathing test was used to challenge HD and ANS. In HP longitudinal changes in all parameters except BP reached significance in trimenon III. In PD significant longitudinal changes could only be found for BP and TPR in trimesterIII. Comparing HP and PD at each gestational time point significant differences could be found only for TPR, BP and BRS especially in trimenon III. The following parameters were changed in PE in comparison to HP: BP (↑), TPR(↑), CI(↓) BPV(↑) and BRS(↑). Women with PE showed siginificant alterations of the ANS parameters especially with the challenge test. The TFM enables a non-invasive measurement and determination of HD and ANS parameters throughout pregnancy and a reproducible basis for examination of pathophysiologic changes in hypertensive disorders in pregnancy. Women with underlying disease show a different pattern at late pregnancy, indicating the higher risk for developing pregnancy complications. Women with PE seem to react differently to challenge tests supporting the theory of ANS-overactivity in this disorder. Additionally, differentiating hypertensive women in hyper- and hypodynamic groups may help in initiating and monitoring individualized antihypertensive treatment strategies.