Hemodynamic patterns of women with chronic hypertension during pregnancy

Abstract

Objective: The purpose of the study was to evaluate the hemodynamic changes during an initial and subsequent gestation of 15 patients with chronic hypertension. Study Design: Data on mean arterial pressure, rapid ejection time, and pulse wave arrival time, recorded at 26 weeks and 37 weeks, were correlated with birth weight and gestational age. Hemodynamic data were acquired with a noninvasive cardiovascular monitor, and blood pressure was recorded with an oscillometric technique. Statistical analyses were performed with the paired Student t test and simple correlation. Results: The birth weights increased in 9 patients and decreased in 6, although more babies were delivered before 37 weeks in the subsequent pregnancy (7 vs 4 patients). No differences were found between the groups of index and repeated pregnancies or among the subgroups whose infant birth weights increased or decreased, except for the pulse wave arrival time at 37 weeks (172 ± 21 ms vs 143 ± 29 ms, P < .05). However, strong correlations emerged between the initial pregnancy’s rapid ejection time versus the mean arterial pressure at week 37 ( r = 0.81, P = .0013) and the repeated pregnancy’s rapid ejection time at week 26 versus the gestational age ( r = –0.95, P = .00003). Conclusion: These observations suggest that rapid ejection time, an empiric indicator of vascular compliance, may have a role in the evaluation and management of hypertension in pregnancy. (Am J Obstet Gynecol 1999;180:1584-92.)