Exercise Induced Improvement of the Venous Reserve Capacity in Formerly Pre-eclamptic Women
Condition: Preeclampsia
MeSH terms: Pre-Eclampsia
Study type: Interventional

Summary: 
      Primary objective:

        -  To investigate whether physical exercise prior to pregnancy in formerly preeclamptic
           women results in a comparable improvement of vascular and endothelial functioning as in
           women who had an uneventful pregnancy.

      Secondary objectives:

        -  Which cardiovascular and endothelial parameters are involved in the vascular adaptation
           to training in women with a history of preeclampsia.

        -  To study the vascular adaptation in the (next) pregnancy in women with a history of
           preeclampsia compared with women with a history of an uncomplicated pregnancy, after
           improvement of their physical condition by exercise training.

      This study is important in order to get a better understanding of the vascular and
      endothelial factors involved in preeclampsia and the effects of training on this profile.
      Results of this study can contribute to the improvement of preventing hypertensive
      complications in pregnancy and reduction of life time risk of cardiovascular disease in
      formerly preeclamptic women.
    

Detailed description: 
      In the Netherlands almost 15.000 women each year develop hypertensive complications like
      preeclampsia during their first pregnancy. In the western world these complications account
      for the most substantial attribution to neonatal and maternal morbidity and mortality. The
      exact etiology of this disease cascade is still unknown. There is accumulating evidence that
      subclinical abnormalities and preexistent haemodynamic, haemostatic and endothelial factors
      are involved, and thought to have negative impact on placental and endothelial functioning.
      The same factors are found to be risk factors for cardiovascular incidents and therefore it
      is not surprising that remotely these women are more at risk for hypertension, cardiovascular
      disease and stroke. Plasma volume has possibly a central role in the disease cascade,
      resulting in decreased cardiovascular reserve capacity. Furthermore a low plasma volume is
      found to be a strong predictor for recurrence of hypertensive complicated pregnancy.
      Adaptation, like in pregnancy, is for a large extent depending on the functioning of the
      venous compartment. In formerly preeclamptic women with low plasma volume is the venous
      compliance and capacitance decreased, furthermore there is sympathic hyperactivity. This
      combination reflects a decreased cardiovascular reserve capacity. These women with low plasma
      volume show a reduced ability to adapt their cardiovascular system to a new pregnancy.

      It is known that physical exercise increases plasma volume in healthy adults, also arterial
      and both venous compliance and capacitance is improved by exercise. Since abnormal
      circulatory functions are common in formerly preeclamptic women, we want to study the effects
      of exercise in this specific group, and compare these results with women after an uneventful
      pregnancy. In preventive perspective it would be beneficial that also formerly preeclamptic
      women show a circulatory adaption to aerobic exercise, possibly they could improve their
      haemodynamic profile prior to their pregnancy
    

Intervention name(s): Aerobic Exercise training
Intervention type(s): Behavioral
Intervention description(s): aerobic exercise training (cycling)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: preeclampsia; low vs high plasma volume