C64-05 Normal Right Heart Echocardiogram Parameters in Pregnancy: A Retrospective Analysis

Rationale Cardiovascular disease in pregnancy accounts for a third of maternal deaths in the United States. In particular, pulmonary hypertension has historically carried up to a 56% maternal mortality. Screening for pulmonary hypertension in pregnancy is typically accomplished with 2D transthoracic echocardiography. However, few studies have investigated the performance of right heart echocardiogram parameters during pregnancy. We completed a retrospective study to determine if differences in right heart parameters exist between pregnant and non-pregnant patients as well as between each trimester of pregnancy. Methods We examined echocardiogram studies previously completed at Tufts Medical Center from April 2022 to March 2025. Women included were between the ages 18-34, had no underlying cardiac disease, and only minor symptoms related to pregnancy. Excluded patients included women with a history of hypertensive disorders of pregnancy, chronic hypertension, pregestational diabetes, underlying cardiac disease, and presence of congenital cardiac anomalies. The right heart parameters that were able to be obtained retrospectively were: Tricuspid Annular Plane Systolic Excursion (TAPSE), Tissue Doppler S’ Velocity, Tricuspid Regurgitation Velocity (TRV) maximum, and Right Ventricular Systolic Pressure (RVSP). The means of these parameters were compared between each trimester of pregnancy utilizing a One-Way Anova test with population established means utilizing a one-sample t-test. Results: Sixty-one patients were found to meet our inclusion criteria (first trimester: 6 patients; second trimester: 20 patients; third trimester: 35 patients). Results revealed significant differences in the mean values of the TVR maximum and RVSP between patients in the first and third trimester. These results are detailed in Table 1. Additionally, 8.7% of patients in the third trimester of pregnancy were noted to have an abnormal TAPSE based on standard parameters established in non-pregnant patients. Conclusion: Our study demonstrates that there are differences between right heart echocardiogram parameters between each trimester of pregnancy. Standard parameters established in non-pregnant patients may also not fully extrapolate to pregnant patients. This data suggests the need for the completion of a prospective study to establish standard right heart echocardiographic parameters in pregnancy to be able to reliably assess for diseases such as pulmonary hypertension that have major implications on morbidity and mortality in this patient population.