Maternal respiratory sinus arrhythmia captures the severity of pre-eclampsia

Abstract

Pre-eclamsia is a gestational disease that leads to hemodynamic disorders, hypoperfusion of end organ and multiple organ failure. Respiratory sinus arrhythmia is known to be participated in regulation of heartrate, cardiac output, blood pressure and peripheral vascular tone. The study was aimed to the survey of respiratory sinus arrhythmia involvement in the maternal cardiovascular system regulation in PE. 116 patients at 28-38 weeks of gestation were enrolled in the study. 30 women with healthy pregnancy were included in Group I (control).In Group II, 49 pregnant women with mild-moderate pre-eclampsia were observed. 37 patients with severe preeclampsia were monitored in Group III. The types of maternal central hemodynamics and maternal heart rate variability were investigated. The decreased autonomic tone was found in pre-eclamptic patients. The increased sympathetic activity in the mild-moderate pre-eclampsia could contribute to better perfusion of end organ. The explored autonomic modulations were associated with gradual decrease of respiratory sinus arrhythmia. Severe pre-eclampsia was featured by dramatic sympathetic overactivity. High peripheral vascular resistance and hypovolemia caused hypoperfusion of end organ in severe pre-eclamptic patients. Therefore, the decreased respiratory sinus arrhythmia was a sign of cardiac failure. Maternal respiratory sinus arrhythmia was an evident biophysical marker of pre-eclampsia and could be used as an additional criterion of its severity.