Estimation of predictive factors for the diagnosis of cardiovascular reactivity in pregnant women
Abstract
Introduction: Pre-eclampsia is a progressive, multisystemic condition characterized by an abnormal vascular response with increased systemic vascular resistance, endothelial dysfunction and platelet aggregation.
Objective: To assess predictive factors of vascular reactivity in women with hypertensive disorder of pregnancy.
Method: An analytical observational study was carried out with 80 pregnant women, selected from a study’s population of 203, with a diagnosis of hypertensive disorder in the 34th week of pregnancy at the Hospital Universitario Ana Betancourt de Mora from Camagüey province, Cuba, between March 2018 to March 2019.
Results: Out of the 80 obstetric patients studied in a one-year period, 27 were hyperreactive (33.7%) and more than half were normoreactive (66.3%). The ROC curve threshold value of 0.503 produced a 29.8% of false positives and an 84.2% of true positives.
Conclusions: More than half of the obstetric patients were diagnosed as normoreactive and one third had cardiovascular hyperreactivity. A positive result of the sustained weight test, cardiovascular reactivity index of blood pressure, P wave dispersion and the presence of chronic high blood pressure, pre-eclampsia, overweight and gestational diabetes were predictive factors of this cardiovascular hyperreactivity.
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1. Semper González AI, Segredo Pérez AM, Hernández Narino A. Calidad de la atención a la morbilidad materna extremadamente grave. Estudio preliminar. Hospital Ginecobstétrico Provincial. Matanzas 2016. Rev Med Electrón. [Internet]. 2017 [citado 14 Ene 2021];39(1):53-60. Disponible en: http://www.revmedicaelectronica.sld.cu/index.php/rme/article/view/1928/pdf_199
2. Redman CW. Fetal outcome in trial of antihypertensive treatment in pregnancy. Lancet. 1976;2(7989):753-6. DOI: https://doi.org/10.1016/s0140-6736(76)90597-3
3. Cockburn J, Moar VA, Ounsted M, Redman CW. Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. Lancet. 1982;1(8273):647-9. DOI: https://doi.org/10.1016/s0140-6736(82)92202-4
4. Majahalme S, Turjanmaa V, Tuomisto M, Lu H, Uusitalo A. Blood pressure responses to exercise as predictors of blood pressure level after 5 years. Am J Hypertens. 1997;10(1):106-16. DOI: https://doi.org/10.1016/s0895-7061(96)00298-1
5. Falkner B. The role of cardiovascular reactivity as a mediator of hypertension in African Americans. Semin Nephrol. 1996;16(2):117-25.
6. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. Guía ESC 2018 sobre el tratamiento de las enfermedades cardiovasculares durante el embarazo. Rev Esp Cardiol. 2019;72(2):161.e1-e161. DOI: http://doi.org/10.1016/j.recesp.2018.12.004
7. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31. DOI: https://doi.org/10.1097/01.aog.0000437382.03963.88
8. Torres-Leyva M, Carrazana-Escalona R, Ormigó-Polo LE, Ricardo-Ferro BT, López-Galán E, Ortiz-Alcolea L, et al. Respuesta autonómica cardiovascular durante la prueba isométrica cubana del peso sostenido. CorSalud [Internet]. 2019 [citado 11 Feb 2021];11(1):1-10. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/342/812
9. Chávez E, González E, Llanes MC, Garí M, García Y, García Sáez J. Relación entre la dispersión de la onda P, el índice de masa ventricular izquierda y la tensión arterial. Arch Argent Pediatr. 2013;111(3):206-12. DOI: http://dx.doi.org/10.5546/aap.2013.206
10. Ministerio de Salud Pública. Protocolos de Atención para Obstetricia y Ginecología. Vol I. 1ª Ed. Santo Domingo: Ministerio de Salud Pública [Internet]; 2016 [citado 17 Feb 2021]. Disponible en: https://repositorio.msp.gob.do/bitstream/handle/123456789/90/Protocolosobtetriciayginecologia.pdf?sequence=1&isAllowed=y
11. Pérez Caballero MD, León Álvarez JL, Dueñas Herrera A, Alfonzo Guerra JP, Navarro Despaigne DA, de la Noval García R, et al. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Rev Cuban Med [Internet]. 2017 [citado 28 Feb 2021];56(4):242-321. Disponible en: http://scielo.sld.cu/pdf/med/v56n4/med01417.pdf
12. Zambrana RE, López L, Dinwiddie GY, Ray RM, Phillips LS, Trevisan M, Wassertheil-Smoller S. Prevalence and incident prehypertension and hypertension in postmenopausal Hispanic women: results from the Women's Health Initiative. Am J Hypertens. 2014;27(3):372-81. DOI: https://doi.org/10.1093/ajh/hpt279
13. Martínez Schulte A. Tabaquismo, alcoholismo y drogadicción en el embarazo. Gineco FLASOG [Internet]. 2019 [citado 12 Mar 2021];11:11-27. Disponible en: https://iddeasmkt.com/flasog/wp-content/uploads/2020/12/REVISTA-FLASOG-NO11_compressed.pdf
14. Smith H, Ameh C, Roos N, Mathai M, Broek NVD. Implementing maternal death surveillance and response: A review of lessons from country case studies. BMC Pregnancy Childbirth [Internet]. 2017 [citado 12 Mar 2021];17(1):233. Disponible en: https://doi.org/10.1186/s12884-017-1405-6
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