Maternal Echocardiography in Hypertensive Pregnancies

Abstract

Echocardiographic hemodynamic and left ventricular parameters were determined in 14 normotensive and 18 hypertensive women during the last trimester of pregnancy. The hypertensive patients had significantly higher mean values of total peripheral resistance (p < 0.001), maximum velocity of posterior wall motion (p < 0.05), mean velocity of circumferential fiber shortening (p < 0.01) and percent fiber shortening of left ventricular diameter (p < 0.05). The mean values for heart rate, stroke volume, cardiac output, cardiac index, left ventricular posterior wall thickness and septal thickness did not differ significantly in both groups. These results reflect increased cardiac contractility related to elevated peripheral vascular resistance in subjects with pregnancy-induced hypertension.

Echocardiographic Study of Cardiac Morphological and Functional Changes before and after Parturition in Pregnancy‐Induced Hypertension

“…Discrepancies in the findings related to systolic function, it was described as increased or remained unchanged. In our study, the EF and shortening fraction increased in PIH patients that in accordance with most of other investigations 5,12 . In Blanco's study, no significant difference was found in shortening fraction between the normal pregnant women and women with PIH 13 .…”

“…The echocardiographic results showed that the end‐diastolic IVS was thickened significantly in PIH compared with that in NP, and the left ventrticular posterior wall was also thickened, although with no significant difference, which demonstrated the asymmetrical hypertrophy in PIH in our study and corresponded with the study conducted by Blanco 4 . While Degani 5 found that no significant differences existed between patients with PIH and women with normal pregnancy in both the thickness of left ventricular posterior wall and the IVS. The discrepancies of these results might be due to the different severity and trimesters of the patients with PIH as they were studied.…”

Changes in maternal heart dimensions and plasma atrial natriuretic peptide levels in the early puerperium of normal and pre‐eclamptic pregnancies

“…We are not aware of earlier data on atrial dimensions in pre‐eclampsia. Earlier ultrasonographic studies have focused on ventricular function and have provided evidence of increased cardiac contractility 6 . The novel findings in the present study were increased left atrial and aortic dimensions and the frequent occurrence of pericardial effusion in pre‐eclamptic women.…”

“…This condition strains the heart, although increased blood pressure and vasospasm may be the underlying factors in this rather than an increase in blood volume. Ultrasonographic studies of the maternal heart have shown an increase in maternal cardiac contractility related to the elevated peripheral vascular resistance observed in pre‐eclampsia 6 . Haemodynamic adjustment in the early puerperium in pre‐eclamptic pregnancies has been insufficiently studied, however, and we are not aware of any data on the puerperal changes in heart dimensions or ANP levels in this condition.…”

Minimally- and non-invasive assessment of maternal cardiac output: go with the flow!

“…19 It may be useful as an adjunct to other haemodynamic monitoring in an elective delivery for a parturient with cardiac compromise. 20,21 The use of this technology in parturients has been extensively explored in a recent review article by Dennis. 22 The advantage of TOE over TTE is that of clearer images due to a reduction in signal attenuation by the chest wall, especially of the aorta, valvular structures, and coronary arteries.…”