Mean arterial blood pressure values of complaint-free pregnant women in the first and second trimesters / Panaszmentes várandósok artériás nyomásértéke a várandósság elso és második trimeszterében

Introduction: The cardiovascular system of women adapts to pregnancy to maintain the growth of the fetus. Objective: The aim of this prospective study is to measure the mean arterial pressure of each gestational week. Hemo-dynamical changes in pregnancy are different in every trimester. Normally the mean arterial pressure decreases at the beginning of the pregnancy, and starts to increase in the third trimester. Method: We have examined 185 pregnant women between May 2020 and July 2020. We used a validated device, TensioMed Arteriograph 2020, which can monitor blood pressure parameters non-invasively. We measured the following parameters: mean arterial pressure, central systolic blood pressure, pulse wave velocity, ankle-brachial index. Results: We found that the mean arterial pressure and the central systolic blood pressure decrease from the 12th to the 15th week, and then start to rise. We did not find significant difference considering the ankle-brachial index and pulse wave velocity. Discussion: The change at the 15th gestational week is the result of circulatory redistribution, histological change when the placenta replaces the chorion. Thus, a high-flow and low-resistance blood flow is created. Compared to the reference values in non-pregnant women, we can say that the values vary significantly within the normal range. Conclusion: Hereafter, we would like to extend our studies to the third trimester as well as to include not only healthy pregnant women, but also pregnant women at risk of developing hypertension. This would create a Hungarian database, which could become a useful pillar in national prenatal care in screening for gestational hypertension.

Evaluation of placental vascularization indices in monochorionic diamniotic and dichorionic diamniotic twin pregnancies.

OBJECTIVES: We aimed to investigate and compare placental vascularization indices between monochorionic-diamniotic, dichorionic-diamniotic normal twin pregnancies, and normal singular pregnancies. We hypothesized that there is correlation between placental three-dimensional power Doppler vascularization indices and birth weight in case of twin pregnancies, and that normal singular pregnancies have higher placental vascularization indices than normal twin pregnancies. STUDY DESIGN: Placental three-dimensional power Doppler vascularization indices, such as vascularization index, flow index, and vascularization-flow index were measured in monochorionic-diamniotic (N = 15) and dichorionic-diamniotic (N = 36) normal twin pregnancies, and in normal singular (N = 109) pregnancies. Correlations were analyzed between vascularization indices, and birth weight, APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess. RESULTS: Vascularization indices and birth weight were significantly (p < 0.01) higher in normal singular gestations (vascularization index = 10.36, flow index = 46.08, vascularization-flow index = 4.08, average birth weight = 3377 g at 38.2 weeks average gestational age) compared to monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. No significant differences were found in vascularization indices between monochorionic-diamniotic and dichorionic-diamniotic normal twins. There were no significant differences in APGAR score, umbilical pH, umbilical venous bicarbonate, lactate, and base excess between groups examined (p < 0.01). We found strong linear correlations between placental vascularization indices and birth weight in both twin groups. CONCLUSION: Placental three-dimensional power Doppler vascularization indices seem appropriate for predicting birth weight in monochorionic-diamniotic and dichorionic-diamniotic normal twin pregnancies. Our pilot study revealed reference values for vascularization indices in case of twin pregnancies examined.