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Influence of maternal characteristics and gestational age on haemodynamic indices: NICOM device-specific reference ranges

Perry, H; Stirrup, O; Gutierrez, J; Vinayagam, D; Thilaganathan, B; Khalil, A; (2019) Influence of maternal characteristics and gestational age on haemodynamic indices: NICOM device-specific reference ranges. Ultrasound in Obstetrics and Gynaecology , 54 (5) pp. 670-675. 10.1002/uog.20179. Green open access

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Abstract

BACKGROUND: There is increasing evidence for the importance of haemodynamic monitoring in pregnancy. Device-specific reference ranges are required in order to correctly intepret hemodynamic indices in healthy and pathological pregnancies. METHODS: This was a prospective cohort study of healthy singleton pregnancies. Haemodynamic measurements of stroke volume, cardiac output and systemic vascular resistance throughout pregnancy were obtained using NICOM® , a non-invasive device based on bio-reactance technology. NICOM device-specific reference ranges were created with respect to gestational age and maternal characteristics. RESULTS: We included 411 women in this study. The relationships shown between cardiac variables and gestational age shown in the NICOM-specific reference ranges are consistent with previous findings, with an increase in cardiac output until around 35 weeks before a decrease to term and converse changes in systemic vascular resitance. Maternal weight, height and age were associated with cardiac output (all p<0.05) and systemic vascular resistance (all p<0.01), whilst maternal weight and height were associated with stroke volume (both p<0.001). Ethnicity was significantly associated with stroke volume (p<0.05) but not with cardiac output or systemic vascular resistance. CONCLUSIONS: This study presents device-specific reference ranges for stroke volume, cardiac output and systemic vascular resistance for the NICOM® device in pregnancy and describes the maternal characteristics that are associated with the values of these haemodynamic measurements. Studies using NICOM® in pregnancy can use these ranges in order to evaluate observations relative to those expected in uncomplicated pregnancies conditional on maternal characteristics. This article is protected by copyright. All rights reserved.

Type: Article
Title: Influence of maternal characteristics and gestational age on haemodynamic indices: NICOM device-specific reference ranges
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/uog.20179
Publisher version: https://doi.org/10.1002/uog.20179
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: maternal haemodynamics, non-invasive cardiac output monitor, pregnancy, reference range
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10065755
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