title: Bioimpedance cardiography in pregnancy: A longitudinal cohort study on hemodynamic pattern and outcome.
abstract: Pregnancy associated cardiovascular pathologies have a significant impact on outcome for mother and child. Bioimpedance cardiography may provide additional outcome-relevant information early in pregnancy and may also be used as a predictive instrument for pregnancy-associated diseases.
  
  
  
  We performed a prospective longitudinal cohort trial in an outpatient setting and included 242 pregnant women. Cardiac output and concomitant hemodynamic data were recorded from 11(th)-13(th) week of gestation every 5(th) week as well as at two occasions post partum employing bioimpedance cardiography.
  
  
  
  Cardiac output increased during pregnancy and peaked early in the third trimester. A higher heart rate and a decreased systemic vascular resistance were accountable for the observed changes. Women who had a pregnancy-associated disease during a previous pregnancy or developed hypertension or preeclampsia had a significantly increased cardiac output early in pregnancy. Furthermore, an effect of cardiac output on birthweight was found in healthy pregnancies and could be confirmed with multiple linear regression analysis.
  
  
  
  Cardiovascular adaptation during pregnancy is characterized by distinct pattern described herein. These may be altered in women at risk for preeclampsia or reduced birthweigth. The assessment of cardiac parameters by bioimpedance cardiography could be performed at low costs without additional risks.
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. martin.andreas@meduniwien.ac.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Andreas
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Kuessel
authors.affiliation: Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria.
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Kastl
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirth
authors.affiliation: Institute for Service Marketing and Tourism, University of Economics and Business, Vienna, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Gruber
authors.affiliation: Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rhomberg
authors.affiliation: Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria.
authors.forename: Fatemeh A
authors.initials: FA
authors.lastname: Gomari-Grisar
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Franz
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Zeisler
authors.affiliation: Department of Internal Medicine II, Division of Cardiology and Angiology all above, Medical University of Vienna, Austria, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Gottsauner-Wolf
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D002307:Cardiography, Impedance; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000503:physiopathology; D064368:Healthy Volunteers; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D049590:Postpartum Period / Q000502:physiology; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy / Q000502:physiology*; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000503:physiopathology*; D011264:Pregnancy Trimesters / Q000502:physiology*; D011446:Prospective Studies; D013318:Stroke Volume; D014655:Vascular Resistance
keywords: Eclampsia; HELLP; High-risk pregnancy; Hypertension in pregnancy; Preeclampsia