The Sympatho-Vagal Balance Significance as a Biophysical Marker of Pre-Eclampsia
Pre-eclampsia (PE) is one of the severe complications of pregnancy that leads to maternal polyorganic failure. The aim of the investigation was to determine the connection between sympatho-vagal balance and the type of maternal central hemodynamics in pregnant women with PE.
Materials and methods. Maternal central hemodynamics and heart rate variability were assessed in 102 patients at 32–37 weeks of gestation. 30 of them had healthy pregnancy and were included into the group I (control one). In the group II, 40 pregnant women with mild to moderate PE were observed. Group III consisted of 32 patients with severe PE.
Results. The maternal heart rate variability has demonstrated an increased hypersympathicotonia on the background of PE. The obtained data supported the well-known hyperdynamic model of the mild to moderate PE. The persistent gestational hypervolemia with the augmented peripheral vascular resistance led to increased cardiac output. Further hemodynamic crossover to hypovolemia and low cardiac output reflected hypodynamic circulation on the background of severe PE. An increase in sympatho-vagal balance was a sign of the vasoconstriction and hypoperfusion. It was confirmed by strong correlation between sympatho-vagal balance and total peripheral vascular resistance (R = 0.70; p < 0.05), sympatho-vagal balance and cardiac index (R = –0.63; p < 0.05).
Conclusion. The increased sympatho-vagal balance more than 2.0 was a biophysical marker of PE.
Rosser M.L., Katz N.T. Preeclampsia: an obstetrician's perspective // Adv. Chronic. Kidney Dis. — 2013. — 20(3). — 287-296.
Hladunewich M., Karumanchi SA., Lafayette R. Pathophysiology of the Clinical Manifestations of Preeclampsia // Clin. J. Am. Soc. Nephrol. — 2007. — 2. — 543-549.
Jerath R., Barnes V.A., Fadel H.E. Mechanism of development of preeclampsia linking breathing disorders to endothelial dysfunction // Med. Hypoth. — 2009. — 73(2). — 163-166.
Tamás P.I.Z., Szilágyi A. Discordant clinical characteristics suggest different pathogenesis of praeeclampsia // J. Perinat. Med. — 2007. — 35(suppl. 2). — 278.
Maeda K. Preeclampsia is caused by continuous sympathetic center excitation due to an enlarged pregnant uterus // J. Perinat. Med. — 2014. — 42(2). — 233-237.
Schobel H.P., Fischer T., Heuszer K. et al. Preeclampsia — a state of sympathetic over activity // N. Engl. J. Med. — 1996. — 335. — 1480-1485.
Yang C.C.H., Chao T., Kuo B.J.K. et al. Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR // American Journal of Physiology — Heart and Circulatory Physiology. — 2000. — 278. — 1269-1273.
Andrietti S., Kruse A.J., Bekkers S.C. et al. Cardiac adaptation to pregnancy in women with a history of preeclampsia and a subnormal plasma volume // Reprod. Sci. — 2008. — 15(10). — 1059-1065.
- There are currently no refbacks.
Copyright (c) 2016 EMERGENCY MEDICINE
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2017