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Project

Development of a screening algorithm for gestational hypertensive disease and intra-uterine growth retardation by 'non-invasive maternal cardiovascular profiling' (R-5191)

Background: Pre-eclampsia is the most important pregnancy-related disorders worldwide. It occurs in 3-5% of all pregnancies. No diagnoses or screening methods exists during the first weeks of gestation. Only when symptoms eventually arise, a conclusive diagnosis is made. At this point cardiovascular adaptations are already completed and irreversible damage to the organs and blood vessels may already be present. The only option to resolve the condition and preserve health of mother and child is child birth. A first trimester screening and early identification of pre-eclamspia is recommended to counter associated adverse effects in time. Goal: My goal will be to develop an early, non-invasive screening method by using impedance cardiography (ICG), electrocardiogram (ECG) -Doppler ultrasonography and bio-impedance in women which are 12 weeks and/or 20 weeks pregnant. The combination of those techniques produces an integrated cardiovascular evaluation of the maternal heart, arteries and veins. Methods: All 12-week pregnant women were informed during their routine consultation at the hospital. The recruited women came back at 20 weeks of gestation. At 12 and 20 weeks the three measurements were done: ICG, ECG-Doppler and bio-impedance. At birth, gestational outcome will be defined and categorized in uncomplicated pregnancy (UP), Gestational Hypertension (GH), Pre-eclampsia (PE) or Intra Uterine Growth Retardation (IUGR), according to the classifications of Sibai et al. Preliminary results: In a preliminary study of our research group, 242 pregnant women were measured around 12 weeks of gestation, using ICG and ECG-Doppler ultrasound. The ICG measurements showed higher blood pressures and decreased aortic flow parameters in women with GH or PE. ECG-Doppler showed no significant results. Conclusion: Maternal cardiovascular function in the first trimester of pregnancy differs between uncomplicated pregnancies and those destined to develop GH, PE or IUGR. However, diseased pregnancies were too low in this preliminary study. Consequently, a larger population is now tested in this PhD project to enforce this preliminary result. Afterwards, a screenings algorithm can be developed, which will be tested in diverse hospitals.
Date:1 Jan 2014 →  31 Dec 2017
Keywords:bio-impedance, electrocardiogram-doppler ultrasound screening, first trimester cardiovascular, impedance cardiography, preeclampsia
Disciplines:Biophysics, Neurosciences, Urology and nephrology, Biological and physiological psychology, Cognitive science and intelligent systems, Developmental psychology and ageing