Echographic findings in patients with pre-eclampsia see at the critical obstetrics unit of the San Jose Children’s Teaching Hospital, 2012-2014
DOI:
https://doi.org/10.18597/rcog.27Keywords:
Preeclampsia, echocardiography, systolic heart failure, diastolic heart failure, ventricular remodellingAbstract
Objective: To describe echographic abnormalities found in patients diagnosed with severe preeclampsia.
Materials and methods: Cross-sectional study describing ultrasound findings in patients with severe preeclampsia (SP) in accordance with the criteria of the American Congress of Obstetricians and Gynecologists. The patients were seen in a referral teaching hospital in Bogota (Colombia), between January 1, 2012 and June 30, 2014. Patients with adequate blood pressure control or with known pre-existing structural heart disease were excluded. Social, demographic and clinical variables are described, as well as the most frequent global echographic findings, also by time of onset. The data are presented using descriptive statistics.
Results: Overall, 228 patients were diagnosed with SP. An echographic examination was performed in 124 and in 8 of them the echographic report was
non-conclusive. Some form of abnormality was found in 78 patients (67 %). Mild pulmonary hypertension [n=34 (29 %)], left-ventricular hypertrophy [n=32 (27 %)], moderate pulmonary hypertension [n=21 (18 %)] and diastolic
dysfunction [n= 16 (13 %)] were the main findings observed. Echographic abnormalities were found more frequently in patients with pre-term SP (69 %)
than in term patients (20 %) or those who developed SP during the post-partum period (11 %). Diastolic dysfunction was found to occur more frequently in patients who developed preeclampsia in the postpartum period.
Conclusions: The prevalence of echographic abnormalities in SP is 67 %, the most frequent being pulmonary hypertension and left ventricular hypertrophy. More studies are needed in order to validate these findings regionally.
Author Biographies
Alejandro Franco-Hernández
Lizzeth Andrea Blanco-Fuentes
Catalina Pinzón-Rey
Saulo Molina-Giraldo
José Luis Rojas-Arias
Edgar Acuña-Osorio
References
Karumanchi SA, Maynard SE, Stillman IE, Epstein FH, Sukhatme VP. Preeclampsia: a renal perspective. Kidney Int. 2005;67:2101-13.
American College of Obstetricians and Gynecologists. Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122:1122-31.
Woelkers D, Barton J, Dadelszen PV, Sibai B. The revised 2013 ACOG definitions of hypertensive disorders of pregnancy significantly increase the diagnostic prevalence of preeclampsia. Pregnancy Hypertens. 2015;5:38.
Garovic VD, August P. Preeclampsia and the future risk of hypertension: the pregnant evidence. Curr Hypertens Rep. 2013;15:114-21.
Ministerio de Salud y Protección Social – Instituto Nacional de Salud. Vigilancia y análisis del riesgo en salud pública. Protocolo de vigilancia en salud pública; morbilidad materna extrema pro-R02.052 Versión 01 2015. Bogotá: Ministerio de Salud y Protección Social – Instituto Nacional de Salud; 2015.
Golmezuglu A, Pattinson R, Hofmeyr G, Lumbiganon P. Global Maternal and Perinatal Health Issues. En: James D, Steer P, Weiner C, Gonik B, editors. High Risk Pregnancy: Management Options. 4th ed. Philadelphia: Elsevier; 2011. p. 1-7.
Warnes C. Pregnancy and Heart Disease. En: Braunwald E. Heart disease. A textbook of cardiovascular medicine. 8th ed. Philadelphia: Saunders WB; 2007. p. 1967.
Nihoyannopoulos P. Cardiovascular Examination in Pregnancy and the Approach to Diagnosis of Cardiac Disorder. En: Oakley C, Warnes C. Heart Diseases in Pregnancy. 2nd ed. Oxford: Blackwell Publishing; 2007. p. 18.
Melchiorre K, Sutherland GR, Watt-Coote I, Liberati M, Thilaganathan B. Severe myocardial impairment and chamber dysfunction in preterm preeclampsia. Hypertens Pregnancy. 2012;31:454-71.
Blackwell SC, Redman ME, Tomlinson M, Berry SM, Sorokin Y, Cotton DB. Severe pre-eclampsia remote from term: what to expect of expectant management. J Matern Fetal Neonatal Med. 2002;11:321-4.
Melchiorre K, Sutherland G, Sharma R, Nanni M, Thilaganathan B. Mid-gestational maternal cardiovascular profile in preterm and term pre-eclampsia: a prospective study. BJOG. 2013;120:496-504.
Melchiorre K, Sutherland GR, Liberati M, Thilaganathan B. Preeclampsia is associated with persistent postpartum cardiovascular impairment. Hypertension. 2011;58:709-15.
Ahmed R, Dunford J, Mehran R, Robson S, Kunadian V. Pre-eclampsia and future cardiovascular risk among women: a review. J Am Coll Cardiol. 2014; 63:1815-22.
Melchiorre K, Thilaganathan B. Maternal cardiac function in preeclampsia. Curr Opin Obstet Gynecol. 2011; 23:440-7.
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1-39.
Domènecha A, Gatzoulis M. Pregnancy and Heart Disease Rev Esp Cardiol. 2006;59:971-84.
Bauer S, Cleary KL. Cardiopulmonary Complications of Pre-eclampsia. Semin Perinatol. 2009;33:158-65.
Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376:631-44.
Bamfo J, Kametas N, Nicolaides K, Chambers J. Maternal left ventricular diastolic and systolic long-axis function during normal pregnancy. Eur J Echocardiogr. 2007;8:360-8.
Hibbard J, Shroff S, Lindheimer M. Cardiovascular Alterations in Normal and Preeclamptic Pregnancy. En: Lindheimer MD, Roberts JM, Cunningham FG, editors. Chesley’s hypertensive disorders in pregnancy. 3 ed. Amsterdam: Elsevier; 2009. p. 249-67.
Melchiorre K, Thilaganathan B. Maternal cardiac function in preeclampsia. Curr Opin Obstet Gynecol. 2011;23:440-7.
Cong J, Fan T, Yang X, Shen J, Cheng G, Zhang Z. Maternal cardiac remodeling and dysfunction in preeclampsia: a three-dimensional speckle-tracking echocardiography study. Int J Cardiovasc Imaging. 2015 Jun 16. [Epub ahead of print].
Rios N, Saldivar D. Imagenología. 3 ed. México: El manual moderno; 2011. p. 514.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
