Maternal cardiac function at 19–23 weeks’ gestation in the p
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First, to examine the factors from maternal characteristics and medical history that affect maternal cardiovascular indices, and second, to examine the potential value of maternal cardiovascular indices at 19-23weeks’ gestation on their own and in combination with the established biomarkers of preeclampsia (PE), including uterine artery pulsatility index (UtA-PI), mean arterial pressure (MAP), serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFLT), in the prediction of subsequent development of PE.

The study population of 2,853 pregnancies contained 76 (2.7%) that developed preeclampsia. The main findings of the study were: first, in pregnancies that subsequently developed PE there was evidence of altered cardiac geometry, impaired myocardial function and increased peripheral vascular resistance; second, all maternal cardiovascular indices were significantly affected by maternal demographic characteristics and elements of medical history known to be associated with increased risk for subsequent development of preeclampsia ; third, after adjustment for maternal demographic characteristics and medical history the only cardiovascular index that was significantly affected by subsequent development of preeclampsia was peripheral vascular resistance; fourth, peripheral vascular resistance MoM was correlated with MAP MoM, which is not surprising because blood pressure is involved in the estimation of both; fifth, there were small correlations between several cardiovascular indices with MAP MoM, but none with MoM values of uterine artery pulsatility index, PlGF or serum soluble fms-like tyrosine kinase-1; sixth, the performance of screening of delivery with preeclampsia at less than 37weeks’ gestation or delivery with preeclampsia at any gestational age in screening by maternal demographic characteristics and medical history or combinations of maternal factors with MAP, UtA-PI, PlGF and sFLT-1 were not improved by the addition of peripheral vascular resistance.

Assessment of maternal cardiovascular function provides information on the pathophysiology of preeclampsia but is not useful in the prediction of preeclampsia.