TY - JOUR T1 - Longitudinal changes in maternal left atrial volume index and uterine artery pulsatility indices in uncomplicated pregnancy. AU - Dobrowolski,Piotr, AU - Kosinski,Przemyslaw, AU - Prejbisz,Aleksander, AU - Szczepkowska,Anna, AU - Klisiewicz,Anna, AU - Januszewicz,Magdalena, AU - Wielgos,Miroslaw, AU - Januszewicz,Andrzej, AU - Hoffman,Piotr, Y1 - 2020/07/24/ PY - 2020/06/01/received PY - 2020/07/10/revised PY - 2020/07/22/accepted PY - 2020/7/28/pubmed PY - 2021/2/17/medline PY - 2020/7/28/entrez KW - Doppler assessment KW - cardiac adaptations KW - echocardiography KW - left atrial volume index KW - pregnancy-associated plasma protein A KW - pulsatility index KW - uncomplicated pregnancy KW - uterine artery KW - volume changes KW - β-human chorionic gonadotropin SP - 221.e1 EP - 221.e15 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 224 IS - 2 N2 - BACKGROUND: Data on the relationship between longitudinal changes in maternal volume-dependent echocardiographic parameters and placentation in uncomplicated pregnancy are limited. OBJECTIVE: This study aimed to evaluate changes in volume-dependent echocardiographic parameters in uncomplicated pregnancy to test the hypothesis of the existence of an association between volume-dependent echocardiographic parameters and Doppler ultrasound parameters of fetal circulation and the uterine artery in uncomplicated pregnancy and to establish which of the volume-dependent echocardiographic parameters best depicts volume changes and correlates best with Doppler ultrasound of fetal circulation and the uterine artery in healthy pregnancy. STUDY DESIGN: Data from 60 healthy pregnant women were analyzed. A complete echocardiographic study was performed at 11 to 13, 20 to 22, and 30 to 32 weeks' gestation: left ventricular end-diastolic volume, early diastolic peak flow velocity, late diastolic peak flow velocity, left atrial area, and left atrial volume index were assessed. Obstetrical assessment was performed including fetal growth and uterine artery pulsatility index. Fetal well-being was assessed by umbilical and middle cerebral artery blood flow. Serum pregnancy-associated plasma protein A and free β-human chorionic gonadotropin were assessed during the routine first-trimester scan (11-13 weeks' gestation). RESULTS: Left ventricular end-diastolic volume and left atrial area increased significantly between 11 to 13 and 20 to 22 weeks' gestation but not between 20 to 22 and 30 to 32 weeks' gestation. Left atrial volume index measured at 30 to 32 weeks' gestation correlated with uterine artery pulsatility indices in 3 trimesters. Changes in the left atrial volume index between the third and first trimesters correlated significantly with the uterine artery pulsatility index measured at 20 to 22 weeks' gestation (r=-0.345; P=.020) and at 30 to 32 weeks' gestation (r=-0.452; P=.002). Changes in the left atrial volume index between the second and first trimesters significantly correlated with the uterine artery pulsatility index measured in the first trimester (r=-0.316; P=.025). CONCLUSION: Our study showed that in an uncomplicated pregnancy, among volume-dependent echocardiographic parameters, left atrial volume index increased between both the first and second trimesters and the second and third trimesters and correlated with parameters of Doppler ultrasound of the fetal circulation and the uterine artery. Our results expand on the previous observation on the relationship between maternal cardiovascular adaptation and placentation in women with heart diseases to the population of healthy women with uncomplicated pregnancy. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/32717256/Longitudinal_changes_in_maternal_left_atrial_volume_index_and_uterine_artery_pulsatility_indices_in_uncomplicated_pregnancy_ DB - PRIME DP - Unbound Medicine ER -