Tullio Ghi1, Daniela degli Esposti2, Elisa Montaguti3, Martina Rosticci2, Sonia Tancredi4, Aly Youssef3, Maria Valentina di Giovanni3, Gianluigi Pilu3, Claudio Borghi2, Nicola Rizzo3. 1. Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: tullioghi@yahoo.com. 2. Department of Internal Medicine, Aging, and Kidney Diseases, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 3. Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 4. Department of Anesthesiology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Abstract
OBJECTIVE: The objective of the study was to evaluate the longitudinal changes in maternal systolic and diastolic function in a series of women carrying an uncomplicated twin pregnancy. STUDY DESIGN: A series of women carrying a twin pregnancy underwent standard M-mode, 2-dimensional color Doppler, and tissue Doppler transthoracic echocardiography during the first (11-13 weeks), the second (20-23 weeks), the third (28-32 weeks) trimesters, and the postpartum (6 months after delivery). RESULTS: From January 2012 to September 2013, 30 women with an uncomplicated twin pregnancy were included in this prospective study. All the pregnancies were diamniotic including 24 dichorionic and 6 monochorionic sets. Overall, 60 live births were observed with a mean gestational age at delivery of 37 ± 1 weeks and a mean birthweight of 2532 ± 313 g. During pregnancy a significant worsening of left ventricle systolic function expressed by ejection fraction, fractional shortening and S1 longitudinal contractility decrease was observed. These findings also persisted at postpartum assessment. Regarding diastolic function, our data showed a significant progressive reduction of pulsed Doppler E-wave velocity and an increase of A-wave from the first to the third trimester. Similar changes were documented for tissue Doppler E1 and A1 peak velocities assessed at the level of the mitral and tricuspid annulus. After delivery diastolic findings returned to values comparable with those obtained in the first trimester. CONCLUSION: In uncomplicated twin gestations, significant changes in maternal systolic and diastolic function occur from the first to the third trimester. Moreover, although diastolic parameters normalize after pregnancy, a relative systolic dysfunction seems to persist after delivery.
OBJECTIVE: The objective of the study was to evaluate the longitudinal changes in maternal systolic and diastolic function in a series of women carrying an uncomplicated twin pregnancy. STUDY DESIGN: A series of women carrying a twin pregnancy underwent standard M-mode, 2-dimensional color Doppler, and tissue Doppler transthoracic echocardiography during the first (11-13 weeks), the second (20-23 weeks), the third (28-32 weeks) trimesters, and the postpartum (6 months after delivery). RESULTS: From January 2012 to September 2013, 30 women with an uncomplicated twin pregnancy were included in this prospective study. All the pregnancies were diamniotic including 24 dichorionic and 6 monochorionic sets. Overall, 60 live births were observed with a mean gestational age at delivery of 37 ± 1 weeks and a mean birthweight of 2532 ± 313 g. During pregnancy a significant worsening of left ventricle systolic function expressed by ejection fraction, fractional shortening and S1 longitudinal contractility decrease was observed. These findings also persisted at postpartum assessment. Regarding diastolic function, our data showed a significant progressive reduction of pulsed Doppler E-wave velocity and an increase of A-wave from the first to the third trimester. Similar changes were documented for tissue Doppler E1 and A1 peak velocities assessed at the level of the mitral and tricuspid annulus. After delivery diastolic findings returned to values comparable with those obtained in the first trimester. CONCLUSION: In uncomplicated twin gestations, significant changes in maternal systolic and diastolic function occur from the first to the third trimester. Moreover, although diastolic parameters normalize after pregnancy, a relative systolic dysfunction seems to persist after delivery.
Authors: Jamil M Kazma; John van den Anker; Karel Allegaert; André Dallmann; Homa K Ahmadzia Journal: J Pharmacokinet Pharmacodyn Date: 2020-02-06 Impact factor: 2.745
Authors: Lina Bergman; Paliz Nordlöf-Callbo; Anna Karin Wikström; Jonathan M Snowden; Susanne Hesselman; Anna Karin Edstedt Bonamy; Anna Sandström Journal: Hypertension Date: 2020-06-01 Impact factor: 10.190