{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T20:28:51Z","timestamp":1774038531545,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Non\u2010invasive assessment of maternal cardiovascular potential and kinetic energy can be used to derive potential\u2010to\u2010kinetic\u2010energy ratio (PKR) and Smith\u2013Madigan inotropic index (SMII), which reflect the balance between blood pressure and blood flow. The aim of this study was to evaluate PKR and SMII in pregnancies complicated by hypertensive disorders of pregnancy (HDP) and\/or small\u2010for\u2010gestational\u2010age (SGA) birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study that enrolled women with a singleton pregnancy between 5 and 41\u2009weeks' gestation. Women who developed HDP and\/or SGA underwent cardiovascular profiling from 20\u2009weeks. To establish reference ranges for PKR and SMII, women without any pre\u2010existing medical problems at the time of booking who did not develop HDP, SGA or other complications during pregnancy were also recruited for cardiovascular profiling. Measurements of cardiovascular parameters were obtained using a non\u2010imaging ultrasound cardiac output monitor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 688 women completed the study, including 626 controls, 21 cases with HDP, 19 cases with SGA and 22 cases with HDP and SGA. PKR was significantly elevated in pregnancies with placental dysfunction compared with controls (HDP only, 29.81\u2009\u00b1\u20099.5; HDP and SGA, 44.33\u2009\u00b1\u200924.27; SGA only, 31.05\u2009\u00b1\u200913.14; <jats:italic>vs<\/jats:italic> controls, 22.30\u2009\u00b1\u20097.93; all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). SMII values were significantly lower only in cases affected by SGA alone when compared with controls (1.47\u2009\u00b1\u20090.23\u2009W\/m<jats:sup>2<\/jats:sup> <jats:italic>vs<\/jats:italic> 1.75\u2009\u00b1\u20090.40\u2009W\/m<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.005). These differences remained statistically significant when the analysis was undertaken using multiples of the median values corrected for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings of this study suggest that point\u2010of\u2010care non\u2010invasive cardiovascular profiling using PKR and SMII may help distinguish between pregnancies affected by specific placental disorders and those exhibiting healthy cardiovascular adaptation to pregnancy. Women with HDP and\/or SGA appear to have distinctive PKR and SMII profiles that reflect low kinetic energy in pregnancies with SGA and high potential energy in pregnancies affected by HDP. Finally, non\u2010invasive assessment of potential and kinetic cardiovascular energy demonstrates physiological high\u2010flow and low\u2010resistance adaptation in uncomplicated pregnancies. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24768","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T14:38:22Z","timestamp":1631803102000},"page":"613-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Maternal cardiovascular potential and kinetic energy indices in pre\u2010eclamptic and small\u2010for\u2010gestational\u2010age pregnancies"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-481X","authenticated-orcid":false,"given":"J.","family":"Gutierrez Henares","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Gutierrez Henares","sequence":"additional","affiliation":[{"name":"Electronic Engineering Malaga University, Campus de Teatinos  M\u00e1laga Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-045X","authenticated-orcid":false,"given":"H.","family":"Perry","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17494"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.10.024"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09256"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2011.08.046"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.162321"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17428"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.06.015"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003664"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17495"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11191"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2014.02.001"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21893"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2018.04.009"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet118"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1201\/b11558"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17504"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20179"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780121003"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1993.03060378.x"},{"key":"e_1_2_6_21_1","unstructured":"Open Learning Initiative.Test of Homogeneity [Internet].Lumen concepts Stat.2018[cited 2018 Oct 11]. 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