Maternal haemodynamic function and angiogenic markers in COVID-19 pregnant patients with and without hypertensive disorders of pregnancy

Objective. To analyse maternal haemodynamic function and endothelial inflammation in pregnant patients affected by COVID-19 with and without HDP compared to healthy preg­nant women.
Materials and Methods. Singleton pregnancies with COVID-19, matched 1:4 with healthy controls of similar ges­tational age and subsequent sub-analysis to compare HDP in COVID-19 and non-COVID-19 patients. All study participants were sampled for measurement sFlt-1/PlGF ratio, and of ma­ternal cardiovascular haemodynamic using the USCOM.
Results. 52 SARS-CoV-2 positive and 311 SARS-CoV-2 nega­tive pregnant women were recruited at our in-patient high-risk Obstetric Unit. Respectively, 19 and 92 pregnant patients admitted were complicated by HDP.
Median sFlt-1/PlGF ratio was the normal range in COVID-19 patients (9; IQR 3.3-27) and non-COVID-19 (5.4; IQR 2.9-13.9). Median sFlt-1/PlGF ratio proved to be non-significantly dif­ferent, even when the sub analysis for HDP was performed: HDP-COVID-19 (28.7; IQR 9.9-69.7) versus HDP-non- COVID-19 (10.7; IQR 4.5-77.8).
Median maternal cardiac output in COVID-19 (6.2 L/min; IQR 5.4-7.1), and non-COVID-19 (5.8 lit/min; IQR 5.1-6.6) and total vascular resistance in COVID-19 (1,080 dynes*; IQR 915-1,370), and non-COVID-19 (1,249 dynes*; IQR 1,061-1,398) were not significantly different between the two cohorts.
When the sub analysis for HDP was performed, we observed significantly higher systemic vascular resistance both in non- COVID-19-HDP, and COVID-19 HDP versus non HDP cas­es, but there were no significantly differences between non COVID-19-HDP and COVID-HDP groups (p = 0.136).
Conclusions. COVID-19 infection did not influence cardiac output and vascular resistances nor increased sFlt-1/PlGF ratio. Even when HDP occurred cardiovascular function was worse in both groups, independently from COVID-19.

Table of Content: Vol. 36 (Supplement No. 1) 2024 – Conference Proceedings

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