Hemodynamic Fetal Response to Maternal Isometric Exercise in Pregnant Patients with Hypertension

Objective: to evaluate the maternal-fetal hemodynamic response with Doppler in pregnant women with chronic arterial hypertension and preeclampsia submitted to controlled isometric activity. Methods: experimental study comparing 50 healthy and 26 hypertensive and 24 preeclamptic pregnant women, from 26 to 36 weeks of gestational age, submitted to isometric contraction with handgrip dynamometer. Maternal hemodynamic parameters (systolic and diastolic blood pressure; heart rate; uterine arteries Doppler) and fetal (heart rate; umbilical artery, middle cerebral and venous duct Doppler) were evaluated before, during and post-isometry. Results: in preeclampsia were observed higher values of blood pressure and uterine artery indexes in all times; middle cerebral artery indexes in the pre and post-isometry; and of maternal heart rate post-isometry. In hypertensive women, systolic blood pressure is increased all the times, with indexes of the right uterine and middle cerebral arteries higher in pre-isometry; middle cerebral and umbilical arteries greater during isometry; and maternal heart rate and umbilical artery indexes bigger after isometry. Conclusion: blood pressure is higher in preeclamptic and hypertension women. The right uterine artery has more resistance in preeclampsia, with a significant decrease in pre to isometry in hypertensive and preeclamptic women; and increased in contraction to post-isometry in healthy and hypertensive women. The left uterine artery increases resistance post-isometry in all groups. The fetal hemodynamic parameters did not show significant differences when comparing the before, during and post-isometry.