A Case Control Study on Echocardiographic Evaluation of Left Ventricular Diastolic Function in Antenatal Women With Pregnancy Induced Hypertension (Pih) Before and After Delivery

Background: Pregnancy-induced hypertension (PIH) is a common cause of maternal and fetal mortality and morbidity. This study aims to evaluate left ventricular diastolic dysfunction using echocardiographic E/A and E/e' in antenatal patients. Methods: This is a case-control study conducted at the Government Chengalpattu Medical College Hospital. We studied 150 cases, 75 of which had PIH, and 75 of which were controls. Controls were both age and gestational age matched with cases. Results: The average E/Aratio of cases vs. controls in the third trimester, 2-4 days postpartum, and 6 weeks postpartum were 0.96 vs. 1.39, 1.24 vs. 1.45, and 1.3 vs. 1.42, respectively. Average E/e' values of cases vs. controls in the third trimester, 2–4 days, and 6 weeks postpartum were 7.9 vs. 6.4, 7.72 vs. 6.24, and 7.15 vs. 5.85, respectively. 17% had persistent diastolic dysfunction at 6 weeks postpartum. 9 out of 13 cases with severe pre-eclampsia went for peripartum cardiomyopathy (PPCM), and all of them had grade II LVDD before delivery. Among the 9 cases with PPCM, 7 were over the age of 33. Conclusion: There is a statistically signicant relationship between the E/e' of cases and controls. E/e' and E/A are useful parameters to detect diastolic dysfunction in PIH patients. Careful evaluation, early diagnosis of PIH/LVDD, optimizing blood pressure levels, and follow-up may help reduce the future risk of heart failure/PPCM.