title: Maternal hemodynamics influence fetal hemodynamics in normal and hypertensive pregnancy.
abstract: OBJECTIVE
  This observational case-control study aims to test whether there is a relationship between maternal systemic hemodynamics, maternal renin-angiotensin system and fetal hemodynamics in normal and hypertensive pregnancy.
  
  
  METHODS
  Four groups of non-pregnant women (n=18), pregnant controls (n=25), women with gestational hypertension (n=21) and preeclampsia (n=10) were included.
  
  
  METHODS
  Maternal echocardiography parameters, plasma renin and aldosterone were correlated with fetal Doppler parameters in third trimester pregnancy.
  
  
  RESULTS
  Higher maternal mean arterial pressure and total peripheral vascular resistance were associated with lower fetal middle cerebral artery pulsatility index (PI) (r=-.51, p<0.01 and r=-.49, p<0.01, respectively); mean arterial pressure correlated negatively with ductus venosus PI (r=-.35, p=0.01); higher maternal plasma aldosterone levels were associated with lower maternal uterine artery resistance (r=-0.33, p=0.03).
  
  
  CONCLUSIONS
  It seems that maternal hemodynamics influence fetal hemodynamics with protective adaptation in fetal cerebral and ductus venosus blood flow observed as maternal blood pressure and vascular resistance increase.
authors.affiliation: Department of Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia; Department of Renal Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia.
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Spaan
authors.affiliation: Division of Women's and Children's Health, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Bowyer
authors.affiliation: Department of Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia; Department of Renal Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia.
authors.forename: Vittoria A
authors.initials: VA
authors.lastname: Lazzaro
authors.affiliation: Division of Cardiology, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: McCrohon
authors.affiliation: Department of Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia; Department of Renal Medicine, St. George Hospital and University of New South Wales, Kogarah, NSW, Australia. Electronic address: mbrown@unsw.edu.au.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Brown
keywords: Fetal Doppler; Maternal hemodynamics; Renin-angiotensin system