A Study of Cardiovascular Hemodynamics in Preeclamptic and Normotensive Pregnancies and its Association with Maternal Outcomes.

BACKGROUND: Preeclampsia (PE) leads to substantial changes in maternal cardiac geometry and function such as elevated afterload which leads to elevated end systolic pressure and reduced emptying of the left ventricle. Systolic and diastolic dysfunction both occurs in preeclampsia where diastolic dysfunction precedes systolic dysfunction. The aim of our study was to assess cardiovascular hemodynamic functions in normotensive and preeclamptic women and its association with maternal outcome. MATERIAL AND METHOD: It was a prospective cohort study conducted in a tertiary healthcare center over one year. One hundred and fifty-eight women, 79 women with PE (group A) and 79 normotensive women (group B), were selected. Echocardiography was performed in all recruited women for maternal outcome. RESULT: The following echocardiographic parameters were higher in preeclamptic subjects as compared to normotensive women: LV ESV (50.40 ± 15.08ml vs. 40.34 ± 5.24ml); LV EDV (103.77±17.78ml vs. 89.23±7.90ml); LV systolic mass(91.28±10.80gm vs 82.90±4.68gm); LV diastolic diameter (4.26 ± 0.35cm vs. 3.93±0.16cm); LV systolic diameter 2.67 ± 0.54cmvs 2.14 ± 0.29cm); E wave (0.86±0.25m/s vs. 0.75±0.07 m/s); and A wave (0.82±0.16m/s vs. 0.64±0.09 m/s). However, parameters such as ejection fraction (55.41 ±11.83% vs. 64.50±3.63%) and E/A ratio (1.06±0.28 vs. 1.17±0.09) were lower in preeclamptic women. Women with abnormal ECHO finding were associated with pulmonary edema, cardiomyopathy, abruptio, eclampsia, and mortality and adverse obstetrical outcomes like abruption, AKI, eclampsia, and HELLP syndrome.