Antihypertensive drugs impact on the regulation of maternal and fetal cardiac activity in pregnant women with preeclampsia

Abstract

Preeclampsia is a serious complication of pregnancy that leads to maternal multiple organ failure and fetal growth retardation. The objective of the study was to investigate the parameters of cardiac activity of mother and fetus affected by antihypertensive therapy for pregnant women with preeclampsia. Types of central maternal hemodynamics based on bioimpedance cardiography, parameters of maternal heart rate variability and fetal electrocardiogram in 72 preeclampsia patients with 32-38 weeks of gestation were examined. The control group was comprised of 30 women with factors associated with physiological pregnancy. In the presence of mild preeclampsia, an increased capacity of the central and peripheral sympathetic regulation of the hemodynamics and almost constant power of the vagal tone were observed. These changes were essential for the hyperkinetic type of central maternal hemodynamics. In the presence of moderate and severe PE, relative hypersympathicotonia associated with reduced heart rate variability was observed. It was accompanied by generalized vascular spasm and decreased cardiac index. The use of carvedilol has contributed to the correction of hypersympatheticotonia with decreased autonomic balance in pregnant women with mild preeclampsia. The use of methyldopa and nifedipine has not had any normalizing effect on total spectrum and separate branches of maternal heart rate variability in pregnant women with moderate and severe preeclampsia. The effect of antihypertensive drugs on the fetal cardiac activity was also not determined.