UMBILICAL BLOOD-FLOW CORRELATED TO MATERNAL HEMODYNAMICS IN SEVERE PREECLAMPSIA

Background: As there are conflicting results concerning maternal hemod ynamics in preeclampsia, this study aimed to evaluate the maternal hem odynamic factors (cardiac output, mean arterial blood pressure, and to tal peripheral resistance) and put them in relation to fetal blood now velocities in the umbilical artery. Methods: Nine primiparous women w ith severe preeclampsia were compared with 9 normotensive controls mat ched for age and gestational age. The maternal cardiac output was meas ured by echocardiography, and the fetal flow velocities using an ultra sound-Doppler technique. The women were examined during the last trime ster and also 6-12 months postdelivery for comparison of pregnant and nonpregnant status. Results: The preeclamptic women who bore small-for -gestational-age (SGA) fetuses had significantly lower cardiac output and higher total peripheral resistance than the normotensive women, bu t the preeclamptic women with appropriate-for-gestational-age (AGA) fe tuses had normal or supernormal cardiac output and normal total periph eral resistance during pregnancy. The flow velocity pattern of the umb ilical artery was pathological in cases with SGA fetuses and normal in the AGA cases. Conclusions: There seems to be a relation between low maternal cardiac output and small-for-gestational-age fetuses with pat hological systolic/diastolic ratio of the umbilical artery.