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Authordc.contributor.authorYoussef, Lina 
Authordc.contributor.authorMiranda, Jezid 
Authordc.contributor.authorPaules, Cristina 
Authordc.contributor.authorGarcía Otero, Laura 
Authordc.contributor.authorVellvé, Kilian 
Authordc.contributor.authorKalapotharakos, Grigorios 
Authordc.contributor.authorSepúlveda Martínez, Alvaro 
Authordc.contributor.authorCrovetto, Francesca 
Authordc.contributor.authorGómez, Olga 
Authordc.contributor.authorGratacós, Eduard 
Authordc.contributor.authorCrispi, Fatima 
Admission datedc.date.accessioned2020-06-03T15:06:49Z
Available datedc.date.available2020-06-03T15:06:49Z
Publication datedc.date.issued2020
Cita de ítemdc.identifier.citationAm J Obstet Gynecol 2020;222:79.e1-9.es_ES
Identifierdc.identifier.other10.1016/j.ajog.2019.07.025
Identifierdc.identifier.urihttp://repositorio.uchile.cl/handle/2250/175180
Abstractdc.description.abstractBACKGROUND: Preeclampsia and fetal growth restriction share some pathophysiologic features and are both associated with placental insufficiency. Fetal cardiac remodeling has been described extensively in fetal growth restriction, whereas little is known about preeclampsia with a normally grown fetus. OBJECTIVE: To describe fetal cardiac structure and function in pregnancies complicated by preeclampsia and/or fetal growth restriction as compared with uncomplicated pregnancies. STUDY DESIGN: This was a prospective, observational study including pregnancies complicated by normotensive fetal growth restriction (n= 36), preeclampsia with a normally grown fetus (n=35), preeclampsia with fetal growth restriction (preeclampsia with a normally grown fetusefetal growth restriction, n+42), and 111 uncomplicated pregnancies matched by gestational age at ultrasound. Fetal echocardiography was performed at diagnosis for cases and recruitment for uncomplicated pregnancies. Cord blood concentrations of B-type natriuretic peptide and troponin I were measured at delivery. Univariate and multiple regression analysis were conducted. RESULTS: Pregnancies complicated by preeclampsia and/or fetal growth restriction showed similar patterns of fetal cardiac remodeling with larger hearts (cardiothoracic ratio, median [interquartile range]: uncomplicated pregnancies 0.27 [0.23-0.29], fetal growth restriction 0.31 [0.26-0.34], preeclampsia with a normally grown fetus 0.31 [0.29-0.33), and preeclampsia with fetal growth restriction 0.28 [0.26-0.33]; P<.001) and more spherical right ventricles (right ventricular sphericity index: uncomplicated pregnancies 1.42 [1.25e1.72], fetal growth restriction 1.29 [1.22-1.72], preeclampsia with a normally grown fetus 1.30 [ 1.33e1.51], and preeclampsia with fetal growth restriction 1.35 [1.27-1.46]; P=.04) and hypertrophic ventricles (relative wall thickness: uncomplicated pregnancies 0.55 [0.48-0.61], fetal growth restriction 0.67 [0.58-0.8], preeclampsia with a normally grown fetus 0.68 [0.61-0.76], and preeclampsia with fetal growth restriction 0.66 [0.58-0.77]; P<.001). Signs of myocardial dysfunction also were observed, with increased myocardial performance index (uncomplicated pregnancies 0.78 z scores [0.32e1.41], fetal growth restriction 1.48 [0.97-2.08], preeclampsia with a normally grown fetus 1.15 [0.75-2.17], and preeclampsia with fetal growth restriction 0.45 [ 0.54-1.94]; P<.001) and greater cord blood B-type natriuretic peptide (uncomplicated pregnancies 14.2 [8.4-30.9] pg/mL, fetal growth restriction 20.8 [13.1-33.5] pg/mL, preeclampsia with a normally grown fetus 31.8 [ 16.4-45.8] pg/mL and preeclampsia with fetal growth restriction 37.9 [ 15.7-105.4] pg/mL; P<.001) and troponin I as compared with uncomplicated pregnancies. CONCLUSION: Fetuses of preeclamptic mothers, independently of their growth patterns, presented cardiovascular remodeling and dysfunction in a similar fashion to what has been previously described for fetal growth restriction. Future research is warranted to better elucidate the mechanism(s) underlying fetal cardiac adaptation in these conditions.es_ES
Patrocinadordc.description.sponsorshipEuropean Union (EU): 2013-0040. La Caixa Foundation: LCF/PR/GN14/10270005. Instituto de Salud Carlos III: PI14/00226, PI15/00130, PI15/00263, PIE15/00027, PI17/00675, CM16/00142. integrados en el Plan Nacional de I+D+I y cofinanciados por el ISCIII-Subdireccion General de Evaluacion y el Fondo Europeo de Desarrollo Regional (FEDER) "Una manera de hacer Europa. Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK). Agencia de Gestio D'Ajuts Universitaris de Recerca Agaur (AGAUR). SGR: 1531. Fundacio Dexeus Mujer.es_ES
Lenguagedc.language.isoenes_ES
Publisherdc.publisherMosby-Elsevieres_ES
Type of licensedc.rightsAttribution-NonCommercial-NoDerivs 3.0 Chile*
Link to Licensedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/*
Sourcedc.sourceAmerican Journal of Obstetrics and Gynecologyes_ES
Keywordsdc.subjectB-type natriuretic peptidees_ES
Keywordsdc.subjectCardiovascular remodelinges_ES
Keywordsdc.subjectFetal echocardiographyes_ES
Keywordsdc.subjectFetal programminges_ES
Keywordsdc.subjectIntrauterine growth restrictiones_ES
Keywordsdc.subjectPregnancy hypertensiones_ES
Keywordsdc.subjectTroponin Ies_ES
Títulodc.titleFetal cardiac remodeling and dysfunction is associated with both preeclampsia and fetal growth restrictiones_ES
Document typedc.typeArtículo de revistaes_ES
Catalogueruchile.catalogadorrvhes_ES
Indexationuchile.indexArtículo de publicación ISIes_ES


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