Szatmári Szilárd, Nagy Dániel T, Kozma Bence, Páll Dénes, Szabó Zoltán, Fülesdi Béla, Hupuczi Petronella
Department of Anesthesiology and Intensive Care, University of Debrecen Faculty of Medicine, 4032 Debrecen, Hungary.
Obstetrics and Gynecology, University of Debrecen, 4032 Debrecen, Hungary.
J Clin Med. 2025 Apr 23;14(9):2897. doi: 10.3390/jcm14092897.
The early recognition of systemic hemodynamic changes resulting from uteroplacental circulation disturbance in preeclampsia (PE) is of great importance for its appropriate treatment and prevention. The aim of the present study was to assess the hemodynamic changes during a roll-over test in healthy normotensive and preeclamptic pregnant women using applanation tonometry. Healthy pregnant and PE women in their third trimester were studied. First, applanation tonometry was performed in a resting state on the right radial artery of each subject. In the second phase, the measurements were repeated in the left-lateral position and 5 min after turning each patient into a supine position (roll-over test = ROT). The systolic and diastolic central and peripheral blood pressures, pulse pressures, and augmentation index (AIx) values were registered for all phases. A total of 21 PE and 14 healthy pregnant women entered this study. At rest, the PE patients had higher systolic, diastolic, and mean blood pressures; the preeclamptic patients had higher peripheral and central blood pressure and pulse pressure values compared to the healthy controls. A statistically significant difference was found between the augmentation index (AIX-75) values for the preeclamptic and healthy pregnant women (healthy pregnant: 9.0 ± 2.4 vs. preeclamptic: 18.9 ± 6.0; = 0.019). During the ROT, no significant differences could be detected in the applanation tonometry parameters within the groups. The differences between the PE and healthy pregnant women continued to exist in the left-lateral and supine positions during the roll-over test. This is the first study combining a roll-over test and arterial stiffness measurements in healthy pregnant females and in those with PE. Although we can confirm that arterial stiffness measurements can be used to detect hemodynamic changes in pregnant women with PE, combining it with a roll-over test is unsuitable for improving the method's sensitivity.
子痫前期（PE）中子宫胎盘循环紊乱导致的全身血流动力学变化的早期识别对于其恰当治疗和预防至关重要。本研究的目的是使用压平式眼压计评估健康血压正常和子痫前期孕妇在翻身试验期间的血流动力学变化。研究了妊娠晚期的健康孕妇和子痫前期孕妇。首先，在静息状态下对每个受试者的右桡动脉进行压平式眼压计测量。在第二阶段，在左侧卧位以及将每位患者转为仰卧位5分钟后（翻身试验=ROT）重复测量。记录所有阶段的收缩压和舒张压、中心和外周血压、脉压以及增强指数（AIx）值。共有21名单纯收缩期高血压患者和14名健康孕妇进入本研究。静息时，子痫前期患者的收缩压、舒张压和平均血压较高；与健康对照组相比，子痫前期患者的外周和中心血压以及脉压值更高。子痫前期孕妇和健康孕妇的增强指数（AIX-75）值之间存在统计学显著差异（健康孕妇：9.0±2.4 vs.子痫前期：18.9±6.0；P=0.019）。在翻身试验期间，各组内的压平式眼压计参数未检测到显著差异。在翻身试验期间，左侧卧位和仰卧位时，子痫前期孕妇和健康孕妇之间的差异仍然存在。这是第一项将翻身试验与健康孕妇和子痫前期孕妇的动脉僵硬度测量相结合的研究。虽然我们可以证实动脉僵硬度测量可用于检测子痫前期孕妇的血流动力学变化，但将其与翻身试验相结合并不适合提高该方法的敏感性。
