Title: Mid-term maternal cardiovascular profile in preterm and term pre-eclampsia: a prospective analysis
Authors: Dr Rabi Narayan Satapathy, Dr Khyamanidhi Sethy, Dr Jyoti Narayan Puhan, Dr Sagar Mohapatra
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.111
Abstract
Aims and Objectives: Maternal cardiovascular system is largely affected in the pathogenesis of preeclampsia. In other words, those women who are destined to develop preeclampsia, severe cardio vascular remodeling with ventricular dysfunction starts during the mid gestational age which differs those who develop preterm preeclampsia than those of term eclampsia. The aim of this study to differentiate what cardiovascular changes occur between these two high risk pregnancy groups during mid gestation who were normotensive during then .
Materials & Methods: This is a prospective analysis taking totally 115 women, including 56 high risk women tend to develop PE as determined by mid-gestational uterine artery Doppler assessment. All women underwent blood pressure monitoring, echocardiography and Doppler assessment between 20-23 weeks of gestation and there cardio vascular profile in women with normal pregnancy and those that subsequently developed preterm preeclampsia and term preeclampsia were compared.
Results: Out of 56 high risk women, 13 women developed PE and 8 developed preterm PE. Irrespective of gestation, 23% preeclamptic women had evidence of concentric left ventricular remodeling which was not found in control women group. 1 out of 8 preterm PE women (12.5%) developed concentric hypertrophy which was not seen in term preeclamptic group also. Only women who developed preterm PE exhibited a high resistance low volume haemodynamic state at mid gestation .They also have evidence of left ventricular diastolic and systolic dysfunction.
Conclusion: Asymptomatic cardiac diastolic dysfunction is evident at mid gestation in women who subsequently develop preterm PE but not in those who develop term PE. Also concentric hypertrophy of LV is mainly associated with preterm PE than term PE group. These cardio vascular changes support preeclampsia is not a single disorder, but a cluster of symptoms that have several different etiologies.
Keywords: PE – preeclampsia, LV – left ventricle,
