Key result
Severe preeclampsia and eclampsia linked to increased SVR and reduced contractility persisting 6 months postpartum.
Why the study?
Maternal cardiac function and hemodynamics in the postpartum period after preeclampsia and eclampsia are not well characterized over time.
Does preeclampsia and eclampsia impair maternal cardiac function in the postpartum period compared to uncomplicated pregnancy?
Cohort (n=145)
Does preeclampsia and eclampsia impair maternal cardiac function in the postpartum period compared to uncomplicated pregnancy?
Preeclampsia and eclampsia lead to prolonged impairment of myocardial contractility and increased peripheral resistance up to 6 months postpartum, suggesting a need for extended cardiovascular monitoring.
INTRODUCTION: The aim of this study is to assess maternal cardiac function in the postpartum period, after 2 and 6 months in the parturient with preeclampsia and eclampsia. MATERIALS AND METHODS: Prospective study: 90 postpartum women after preeclampsia and eclampsia and 55 patients after an uncomplicated pregnancy. The parameters of maternal hemodynamics were recorded on days 1, 3, 5, 9, and 14 of postpartum period, after 2 and 6 months. The cardiac parameters were assessed. RESULTS: PE is accompanied by increased peripheral vascular resistance. The indicator of vascular resistance, SVR, is elevated for both mild and severe PE. With mild PE, a significant increase in SVR is observed up to 5 days of postpartum period, with severe PE/E up to 9 days. We found that in case of severe PE, SVR remains elevated to 6 months after delivery. The parameters of the contractile function of the heart (ESV, EDV, SV, SI, CO, СI, MVCF) were significantly decreased: with mild PE up to 5-9 days, with severe up to 9-14 days of puerperia. ESV, SV, SI, CO, and CI remain low with severe PE up to 6 months. The revealed decreasing of contractile function of the heart is a sign of asymptomatic heart failure. CONCLUSIONS: The hemodynamics of the puerperas after PE and E is characterized by impaired contractility of the myocardium and an increase in the indices of peripheral resistance. The degree of deviation in the parameters of cardiac hemodynamics and vascular resistance depended on the severity of hypertensive complications of pregnancy.
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Тимохина et al. (2019) conducted a cohort in Preeclampsia and eclampsia (n=145). Preeclampsia and eclampsia vs. Uncomplicated pregnancy was evaluated on Maternal cardiac function and hemodynamics. Preeclampsia and eclampsia were associated with increased systemic vascular resistance and decreased myocardial contractility that persisted up to 6 months postpartum in severe cases.
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