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Is there a correlation between total body water distribution and haemodynamic changes during pregnancy?

Pisani I, Lo Presti D, Tiralongo GM, Gagliardi G, Farsetti D, Vasapollo B, Novelli Andreoli A, Valensise H

Presented: Second International Congress on Maternal Haemodynamics Second International Congress on Maternal Haemodynamics, Rome, 12-14 May 2016 Abstract F1

Published: Second International Congress on Maternal Haemodynamics Handbook- Abstract F1

Introduction: During pregnancy, maternal body composition and haemodynamics undergo important changes which are of increasing interest for understanding the evolving maternal physiology.

Targets: To assess and correlate changes in body composition and haemodynamic function of healthy normotensive pregnant women. To identify different populations based on TVR values. We enrolled 235 patients subjected to bioimpedance analysis and haemodynamic assessment using the USCOM system.

Results: We found an increase of BMI resulting as an increase of all its components and a change in water distribution: ECW percentage increases while ICW decreases (see table). As regard haemodynamics, we observed an increase in CO, SV and HR during all trimesters and a decrease in TVR. We divided patients in two groups according to TVR values: we found lower TBW in patients with high TVR during the second trimester of pregnancy (see figure).

Conclusions: Assessment of BMI is unable to disentangle the components of weight gain. TBW is strictly related with plasma volume expansion and has a primary importance for cardiac function enhancement. Assessment of TBW and TVR may identify patients with different adaptation to pregnancy: women with high TVR and insufficient plasma volume expansion and women with high TVR and excessive fluid retention.