Arterial stiffness during pregnancy and after delivery

Abstract

Background. Physiological pregnancy from conception to birth affects both the woman’s body as a whole and cardiovascular system, in particular. In some cases, there is a failure of adaptive mechanisms of the cardiovascular system without clinical manifestations. As a consequence, such complications as pre-eclampsia, hypertension, pregnancy, fetal growth retardation syndrome and others can develop. Objective . To evaluate the indicators of arterial rigidity, and their association with blood pressure, heart rate, age, parameters of Doppler study of uterine arteries during pregnancy and after delivery. Design and methods. In a cohort prospective study, 31 women with physiological pregnancy without somatic pathologies were included (age from 19 to 34 years, mean age 26 years). The following parameters were assessed: arterial stiffness and Doppler study of uterine artery blood flow, anthropometric and clinical indicators. Results. On average, the studied values vary within 7 % during pregnancy. There was a significant association between age and augmentation index, arterial rigidity index in the second trimester. Pulse wave velocity increases by the third trimester, and returns to the baseline values in postpartum period. Arterial rigidity index increases throughout gestation period. In the third trimester, uterine artery hemodynamics (including the systolic-diastolic ratio, pulse index and resistance index) varies depending on the time of the reflected wave propagation. In the early postpartum period, augmentation index decreases, at the same time heart rate raises significantly. A strong association between arterial rigidity index and the time of the reflected wave propagation is observed. Conclusions. The indicators of arterial stiffness, measured by the used technique, demonstrate adaptive changes during pregnancy and are promising to forecast potential cardiovascular diseases associated with arterial elasticity changes.