{
    "abstract": "Preeclampsia is among the most common medical complications of pregnancy. The clinical utility of invasive hemodynamic monitoring in preeclampsia (e.g., Swan-Ganz catheter) is controversial. Thoracic impedance cardiography (TIC) and Doppler echocardiography are noninvasive techniques but they both have important limitations. NICaS\u2122 (NI Medical, PetachTikva, Israel) is a noninvasive cardiac system for determining cardiac output (CO) that utilizes regional impedance cardiography (RIC) by noninvasively measuring the impedance signal in the periphery. It outperformed any other impedance cardiographic technology and was twice as accurate as TIC.\nWe used the NICaS\u2122 system to compare the hemodynamic parameters of women with severe preeclampsia (PET group, n\u2009=\u200917) to a cohort of healthy normotensive pregnant women with a singleton pregnancy at term (control group, n\u2009=\u200962) (1/2015-6/2015). Heart rate (HR), stroke volume (SV), CO, total peripheral resistance (TPR) and mean arterial pressure (MAP) were measured 15-30\u00a0min before CS initiation, immediately after administering spinal anesthesia, immediately after delivery of the fetus and placenta, at the abdominal fascia closure and within 24-36 and 48-72\u00a0h postpartum.\nThe COs before and during the CS were significantly higher in the control group compared to the PET group (P\u2009<\u2009.05), but reached equivalent values within 24-36\u00a0h postpartum. CO peaked at delivery of the newborn and the placenta and started to decline afterwards in both groups. The MAP and TPR values were significantly higher in the PET group at all points of assessment except at 48-72\u00a0h postpartum when it was still significantly higher for MAP while the TPR only exhibited a higher trend but not statistically significant. The NICaS\u2122 device noninvasively demonstrated low CO and high TPR profiles in the PET group compared to controls.\nThe immediate postpartum period is accompanied by the most dramatic hemodynamic changes and fluid shifts, during which the parturient should be closely monitored. The NICaS\u2122 device may help the clinician to customize the most optimal management for individual parturients. Our findings require validation by further studies on larger samples.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel. netkin@hotmail.com.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. netkin@hotmail.com.",
            "firstname": "Anat",
            "initials": "A",
            "lastname": "Lavie"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Maya",
            "initials": "M",
            "lastname": "Ram"
        },
        {
            "affiliation": "General ICU, Hasharon Hospital, Rabin Medical Center, Petach Tikva, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Shaul",
            "initials": "S",
            "lastname": "Lev"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Yair",
            "initials": "Y",
            "lastname": "Blecher"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Uri",
            "initials": "U",
            "lastname": "Amikam"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Yael",
            "initials": "Y",
            "lastname": "Shulman"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Tomer",
            "initials": "T",
            "lastname": "Avnon"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Eran",
            "initials": "E",
            "lastname": "Weiner"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Lis Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.\nSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Ariel",
            "initials": "A",
            "lastname": "Many"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1186/s12884-018-1861-7\n10.1016/j.ejogrb.2013.05.005\n10.1097/01.AOG.0000437382.03963.88\n10.1016/S0146-0005(03)00022-3\n10.1016/j.bpobgyn.2011.01.006\n10.1016/S0095-5108(18)30493-7\n10.1097/00000658-197601000-00014\n10.1056/NEJM197008272830902\n10.1016/j.jcrc.2003.08.006\n10.1016/S0140-6736(05)67061-4\n10.1016/j.amjhyper.2004.11.002\n10.1016/0029-7844(95)00348-7\n10.1253/circj.70.1164\n10.1378/chest.125.4.1431\n10.1088/0967-3334/27/9/005\n10.1038/jp.2017.53\n10.1007/s00404-017-4601-8\n10.1097/00003081-199235020-00018\n10.1016/0002-9378(89)90901-0\n10.1016/j.ejogrb.2004.12.018\n10.1016/S0002-9378(84)90357-0\n10.1161/01.HYP.17.6.1072\n10.1111/j.1471-0528.2006.00931.x\n10.1016/0002-9378(89)90869-7\n10.1097/01.AOG.0000298622.22494.0c\n10.1111/j.1399-6576.1985.tb02178.x\n10.1111/j.0001-6349.2005.00489.x\n10.1016/j.ccl.2012.05.004\n10.1097/ALN.0b013e31829416dd\n10.1016/0002-9378(89)90900-9\n10.1152/ajpregu.00562.2002\n10.1172/JCI107462\n10.1097/01.CCM.0000183156.73560.0C\n10.3906/sag-1207-1\n10.1016/j.accpm.2015.02.007\n10.1093/bja/aep003\n10.1097/00004311-198902710-00007\n10.1016/j.ijgo.2006.05.032\n10.1097/01.AOG.0000128170.15161.1d\n10.1016/0002-9378(70)90554-5\n10.1016/0002-9378(89)90184-1\n10.1081/BIP-100104194",
    "journal": "BMC pregnancy and childbirth",
    "keywords": [
        "Cardiac output (CO)",
        "Cesarean section (CS)",
        "Hemodynamics",
        "Preeclampsia with severe features",
        "Pregnancy"
    ],
    "methods": null,
    "publication_date": "2018-06-15",
    "pubmed_id": "29898711\n23746796\n24150027\n12889591\n21333604\n1764880\n1108813\n13494664\n5434111\n14595569\n16084255\n15752931\n8559545\n16936430\n15078756\n16868348\n28406485\n29189893\n1638828\n2603896\n16054954\n6486190\n2045151\n16709208\n2567574\n10576186\n18238965\n2234714\n2705548\n3976328\n15762965\n22813360\n2787489\n23598289\n2603895\n12429557\n4355997\n16215359\n25566589\n26388504\n19218369\n2646231\n1153152\n16920118\n15228996\n5445003\n2729392\n11459446",
    "results": "The COs before and during the CS were significantly higher in the control group compared to the PET group (P\u2009<\u2009.05), but reached equivalent values within 24-36\u00a0h postpartum. CO peaked at delivery of the newborn and the placenta and started to decline afterwards in both groups. The MAP and TPR values were significantly higher in the PET group at all points of assessment except at 48-72\u00a0h postpartum when it was still significantly higher for MAP while the TPR only exhibited a higher trend but not statistically significant. The NICaS\u2122 device noninvasively demonstrated low CO and high TPR profiles in the PET group compared to controls.",
    "title": "Maternal cardiovascular hemodynamics in normotensive versus preeclamptic pregnancies: a prospective longitudinal study using a noninvasive cardiac system (NICaS\u2122).",
    "xml": "<Element 'PubmedArticle' at 0x788504ef77e0>"
}