Maternal left ventricular systolic and diastolic function during second trimester of pregnancy with preeclampsia

Abstract

Objective: This study was done to assess maternal cardiovascular function using echocardiography in normal and preeclamptic women in the second trimester of pregnancy. Materials and Methods: This cross-sectional study was conducted at Prathima Institute of Medical Sciences (PIMS), Karimnagar, Telangana, India between February 2012 and October 2013. Doppler echocardiography was performed in 15 normotensive controls (Group I) and 15 pregnant women with hypertension (Group II) at 20-24 weeks of gestation. Baseline characteristics and maternal and fetal outcome were studied with systolic and diastolic parameters on echocardiography. Results: The following parameters were higher in preeclamptic subjects as compared to normotensive controls: Mean cardiac output (CO) (6642 ± 1508 mL/min vs 5175 ± 1279 mL/min); mean left ventricular (LV) mass, I.E., LVM (121.15 ± 16.55 g vs 104.90 ± 23.17 g); total vascular resistance (TVR) (1286.85 ± 106.2 dyn.s/cm 5 vs 1236.5 ± 68.18 dyn.s/cm 5 ). Women with preeclampsia delivered smaller babies (2510 ± 200.16 g) as compared to normotensive controls (2895 ± 276.20 g). Student′s t-test was used as a test of significance. Conclusion: Women with preeclampsia in the second trimester have significantly high CO and systolic and diastolic dysfunction compared to normotensive controls. Blood pressure (BP) monitoring alone is insufficient to effectively identify the risk of cardiovascular complications in these subjects. Echocardiography is a noninvasive method to evaluate the maternal hemodynamic during the second trimester and can help to identify high-risk patients before development of preeclampsia, and thus it may improve the outcome of pregnancy.

Keywords

• Diastolic
• echocardiography
• maternal
• normal
• preeclampsia
• systolic