PM.41 Can Pulse Wave Analysis Predict Adverse Obstetric Outcome in Pregnant Women with Chronic Hypertension?

Abstract

Introduction Complications of pregnancy including super imposed pre-eclampsia (PE), fetal growth restriction (FGR) and preterm delivery are common in women with chronic hypertension. Outside of pregnancy measurement of arterial stiffness using pulse wave analysis is highly predictive of future cardiovascular events. We aimed to assess the utility of pulse wave analysis in pregnancy in a cohort of women with chronic hypertension. Methods Using the Tensioclinic™ arteriograph, women with hypertension attending a specialist clinic had longitudinal haemodynamic measurements taken at three time points from early pregnancy. Measurements included peripheral BP, central BP and pulse wave velocity (PWv). Results To date pregnancy outcome data are available in 24 women. In women with an adverse obstetric outcome (preterm delivery, superimposed PE and/or FGR; n = 14) the median gestation at delivery was 36.5 (26-38) vs 37.8 (37-39) weeks in the good outcome group (n = 10). Customised birthweight centiles were significantly lower in the poor outcome group [10 (0-86) vs 67 (15-96); p < 0.05], BMI was not different between the groups. There was a trend towards a higher PWv in the poor outcome group at 16 weeks 9.29 ± 1.66 vs 8.21 ± 1.06 m/s (p = 0.09). Peripheral (101 ± 10.6 vs 97.9 ± 8.6 mmHg) and central (90.5 ± 9.9 vs 87.2 ± 8.7 mmHg) mean arterial pressure were not different between the groups at the same gestation. There was no difference in the PWv between the groups at 22 weeks gestation. Conclusion Measures of arterial stiffness in early pregnancy may be more informative than blood pressure measurements alone in the prediction of adverse pregnancy outcome in women with chronic hypertension.