Total body water estimation and maternal cardiac systolic function assessment in normal and gestational hypertensive pregnant women.
BACKGROUND
The importance of establishing correlations between cardiac function (cardiac output and stroke volume) and total body water (TBW) content in normal and hypertensive pregnancy focuses primarily on their potential relevance in treatment. Total body water content and cardiac function were evaluated in 25 normotensive (N) and 22 gestational hypertensive (GH) pregnant women matched for age, gestational age, and pre-pregnancy body mass index (BMI) during the third trimester of gestation.


METHODS
Patients underwent maternal echocardiography, bioelectrical impedance analysis (BIA), and hematocrit (Hct) evaluation, and the water balance index (WBI), i.e. the ratio of total body water to hematocrit, was computed. Hematocrit showed significantly lower values in normal than in GH women (31.9+/-2.2% vs. 36.2+/-2.5%; p<0.001).


RESULTS
There was no difference in TBW between the two groups. The WBI was higher in normal than in GH women (1.35+/-0.20 l.kg-1.m-2 vs. 1.19+/-0.18 l.kg-1.m-2; p<0.001). Normal subjects showed a higher stroke volume than GH patients (78.0+/-9.7 ml vs 67.9+/-10.2 ml; p=0.001). Atrial function was also higher in normal than in GH women (left atrial fractional area change: 57.4+/-5.1% vs. 42.5+/-7.5%; p<0.001). Correlation was found between stroke volume and WBI (r=0.93, p<0.0001).


CONCLUSIONS
Maternal cardiac function and the water balance index are strongly related and might help in comprehending the mechanisms of adaptation in physiologic and hypertensive pregnancy.
Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy. valensise@med.uniroma2.it
Herbert
H
Valensise
Barbara
B
Vasapollo
Gian Paolo
GP
Novelli
Giovanni
G
Larciprete
Angela
A
Andreoli
Francesco
F
Altomare
Giuseppe
G
Di Pierro
Alberto
A
Galante
Domenico
D
Arduini
Antonino
A
De Lorenzo
D000222:Adaptation, Physiological; D000328:Adult; D016279:Atrial Function, Left; D001834:Body Water; D004452:Echocardiography; D005260:Female; D006334:Heart Function Tests; D006400:Hematocrit; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D011247:Pregnancy; D013223:Statistics as Topic; D013599:Systole / Q000502:physiology*