Authors:
H. Malberg
1
;
R. Bauernschmitt
2
;
T. Walther
3
;
A. Voss
4
;
Renaldo Faber
5
;
Holger Stepan
5
and
N. Wessel
6
Affiliations:
1
Karlsruhe Research Center, Institute for Applied Computer Science, Germany
;
2
Clinic for Cardiovascular Surgery, German Heart Center Munich, Germany
;
3
Charité, Campus Benjamin Franklin (CBF), Germany
;
4
University of Applied Sciences, Germany
;
5
University of Leipzig, Germany
;
6
University of Potsdam, Germany
Keyword(s):
Heart Rate Variability, Blood Pressure Variability, baroreceptor reflex; screening, risk stratification.
Related
Ontology
Subjects/Areas/Topics:
Applications and Services
;
Biomedical Engineering
;
Biomedical Signal Processing
;
Computer Vision, Visualization and Computer Graphics
;
Medical Image Detection, Acquisition, Analysis and Processing
;
Physiological Processes and Bio-Signal Modeling, Non-Linear Dynamics
Abstract:
Pre-eclampsia is a serious disorder with high morbidity and mortality occurring during pregnancy; 3%–5% of all pregnant women are affected. Although most pre-eclamptic patients show pathological uterine perfusion in the second trimester, this parameter has a positive predictive accuracy of only 30%, which makes it unsuitable for early, reliable prediction. The study is based on the hypothesis that alterations in cardiovascular regulatory behavior can be used to predict PE. Ninety-six pregnant women in whom Doppler investigation detected perfusion disorders of the uterine arteries were included in the study. Twentyfour of these pregnant women developed PE after the 30th week of gestation. During pregnancy, additional several non-invasive continuous blood pressure recordings were made over 30 min under resting conditions by means of a finger cuff. In the period between the 18th and 26th weeks of pregnancy, three special variability and baroreflex parameters were able to predict PE seve
ral weeks before clinical manifestation. Discriminant function analysis of these parameters was able to predict PE with a sensitivity and specificity of 87.5% and a positive predictive value of 70%. The combined clinical assessment of uterine perfusion and cardiovascular variability demonstrates the best current prediction several weeks before clinical manifestation of PE.
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