Hemodinamica maternă în sarcina gemelară evaluată cu impedanţa cardiacă.

Introduction. Impedance cardiography (ICG) technique measures the variation in impedance that appears in thorax due to the physical contractile activity of the heart. Twin pregnancy is characterized by greater maternal hemodynamic changes than singleton pregnancy. Materials and method. We evaluated pregnant women in the last trimester of pregnancy using impedance cardiography technique. There were measured: the stroke volume (SV), the heart rate (HR), the cardiac output (CO), the ventricular ejection time (VET), the left ventricular ejection time (LVET), the thoracic impedance (Z0), and the systemic vascular resistance (SVR). Results. Our study included a number of 40 pregnant women divided equally between twin and singleton pregnancies. Heart rate values in women with single fetus (median: 85 beats/min) was reduced significantly compared with twins (median: 100 beats/min), p=0.021. SV values in women with singleton (median: 64 ml) differed significantly versus twin pregnancy (median: 83 ml), p=0.010. Cardiac output in women with singleton was lower than in twin pregnancies (p<0.0001). The systemic vascular resistance was decreased in twin pregnancies compared to singleton pregnancies (p=0.023). Conclusions. Using ICG technique in the third trimester of pregnancy, we observed that SV, HR and CO were increased in twin pregnancy compared with singleton pregnancy, whereas systemic vascular resistance was decreased in twin pregnancies. Impedance cardiography can be a reliable technique to evaluate maternal hearth changes in twin pregnancy, but longitudinal studies are required to validate the results. [ABSTRACT FROM AUTHOR]