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September 1, 2019International Journal of Clinical Obstetrics and GynaecologyOpen Access

A study on mid gestational maternal cardiovascular profile in pre term and term pre-eclampsia: A prospective study

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Key result

High-risk pregnant women destined to develop preterm pre-eclampsia exhibited a significantly higher prevalence of altered cardiac geometry (62.5%) and diastolic dysfunction (62.5%) at mid-gestation compared to those developing term pre-eclampsia.

Why the study?

Pre-eclampsia is linked to maternal cardiac remodelling and diastolic dysfunction, but whether mid-gestational cardiovascular profiles differ between women destined to develop preterm versus term pre-eclampsia was unclear.

Does the maternal cardiovascular profile at mid-gestation differ in nulliparous women destined to develop preterm pre-eclampsia versus term pre-eclampsia or uneventful outcomes?

Population

115 nulliparous mid-gestational pregnant women with singleton pregnancy

Comparison

Low risk uneventful vs high risk uneventful vs high risk term PE vs high risk preterm PE

Design

Prospective study

Authors

BSBarsha SahuRSRN Satapathy

Discussion

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Member takes

Overview

May flag preterm pre-eclampsia risk via mid-gestation cardiac screening; hypothesis-generating and requires prospective validation before practice change.

Study Design

Type

Cohort (n=115)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does the maternal cardiovascular profile at mid-gestation differ in nulliparous women destined to develop preterm pre-eclampsia versus term pre-eclampsia or uneventful outcomes?

P
Population
115 nulliparous normotensive pregnant women at 20-23 weeks of gestation were prospectively followed to assess mid-gestational maternal cardiovascular profiles and predict the development of preterm versus term pre-eclampsia.
E
Exposure
High risk for developing pre-eclampsia (mean uterine artery pulsatility index > 95th percentile at 20-23 weeks gestation), specifically observing those who subsequently developed preterm or term pre-eclampsia.
C
Comparator
Low risk women with normal uterine artery Doppler pulsatility index and uneventful pregnancy outcome.
O
Outcome
Maternal cardiovascular profile at mid-gestation (including mean arterial pressure, heart rate, stroke volume, cardiac output, cardiac index, left ventricular mass index, left ventricular wall thickness, E/A ratio, left atrial volume index, and ejection fraction).surrogate

Main Result

Absolute Event Rate: 62.5% vs 23.1%

p-value: p=0.000

Asymptomatic cardiac diastolic dysfunction, impaired relaxation, and altered geometry at mid-gestation are detectable in high-risk pregnant women destined to develop preterm pre-eclampsia, providing early markers for cardiovascular risk.

Limitations

  • Small sample size, particularly in the preterm pre-eclampsia group (n=8)
  • Inability to distinguish pre-existing cardiac dysfunction from that acquired as a result of pregnancy

Cite This Study

Sahu et al. (2019) conducted a cohort in Pre-eclampsia (n=115). Development of preterm pre-eclampsia vs. Development of term pre-eclampsia was evaluated on Altered cardiac geometry at mid-gestation (p=0.000). High-risk pregnant women destined to develop preterm pre-eclampsia exhibited a significantly higher prevalence of altered cardiac geometry (62.5%) and diastolic dysfunction (62.5%) at mid-gestation compared to those developing term pre-eclampsia.

synapsesocial.com/papers/6a207bbc04d2adee4bf49511https://doi.org/10.33545/gynae.2019.v3.i5b.339
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessment of left ventricular structure and function in preeclampsia by echocardiography and cardiovascular biomarkers2009 · 172 citations
  2. 2Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy2002 · 296 citations
  3. 3Maternal Cardiovascular Impairment in Pregnancies Complicated by Severe Fetal Growth Restriction2012 · 112 citations
  4. 4Maternal total vascular resistance and concentric geometry: a key to identify uncomplicated gestational hypertension2006 · 71 citations
  5. 5Maternal Body Mass Index and the Risk of Preeclampsia: A Systematic Overview2003 · 644 citations