A Comparative Study of Echocardiographic Parameters between Pregnant Women with New Onset Hypertension and Normotensive Pregnant Women after 28 Weeks of Gestational Age

Background Cardiac disease is being the leading non obstetric cause of death in pregnancy and puerperium. Hypertensive disorders constitute 5-10% of all pregnancies, being one of the components of deadly triad with hemorrhage and infection. Preeclampsia is a pregnancy complication of placental etiology with acute onset of predominantly cardiovascular manifestations and constitutes 2-7% of medical disorders in pregnancies. In India, preeclampsia accounts for approximately 8-14% of maternal deaths. There is limited knowledge with respect to parameters of cardiac function in pregnancy and even less in the presence of pregnancy complications such as preeclampsia. In preeclampsia mean arterial pressure and total vascular resistance are increased resulting in increased afterload on heart. Transthoracic echocardiography is frequently considered the reference standard for cardiovascular system monitoring. It is a non-invasive, precise device and is validated in pregnancy. Aim & Objective:To compare the echocardiography parameters in pregnant women with new onset hypertension and normotensive pregnant women after 28 weeks of gestational age. Methods:This is a hospital based observational case control study carried out in the departments of obstetrics and gynecology and cardiology at Gandhi hospital during the study period. Patients were enrolled in the study after applying the inclusion and exclusion criteria. On admission subjects are assessed clinically, appropriate biochemical tests done. • The subjects were studied by standard 2 – dimensional and Doppler transthoracic echocardiography in the left lateral decubitus position and data acquired at end expiration from standard parasternal/apical views. Results:In the present study, it is observed mean heart rate is 82.9bpm in cases and 84 bpm in controls. It is observed that mean stroke volume index in cases is 39.05 and in controls is 39.06. Cardiac work index (CWI) is increased in cases compared to controls. Mean CWI in cases is 385 and in controls are 288.89. Mean E wave velocity in cases is 0.79 m/s and in controls are 0.82 m/s. A wave is increased in cases which is statistically significant. Mean A wave velocity in cases is 0.65 m/s and in controls is 0.60 m/s. E/A ratio is reduced in cases which is statistically significant. Mean E/A ratio in cases is 1.22 and in controls is 1.35. In the present study it is observed Left ventricular mass index (LVMI) is increased in cases compared to controls. Mean LVMI in cases is 75.26 gm/m2 and in controls is 70.48 gm/m2. Conclusion:Preeclampsia is a multisystem disease complicating 5-10% of pregnancies and remains in the top three causes of maternal morbidity and mortality globally. In women with preeclampsia cardiac work index ,left ventricular mass index,left ventricular posterior wall diameter and interventricular septal thickness are increased as a result of increased workload on heart to maintain cardiac output against increased after load.Systolic function is well preserved. Diastolic function is reduced and those with global diastolic dysfunction are at increased risk of developing pulmonary edema. ------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 18-12-2019 Date of Acceptance: 01-01-2020 -------------------------------------------------------------------------------------------------------------------------------------A Comparative Study of Echocardiographic Parameters between Pregnant Women with New Onset . DOI: 10.9790/0853-1812120713 www.iosrjournals. org 8 | Page