Echocardiographic study of cardiac morphological and functional changes before and after parturition in pregnancy-induced hypertension

PURPOSE: To investigate the cardiac morphological and functional changes by echocardiography, before and after parturition in patients with pregnancy-induced hypertension (PIH). METHODS: The parameters related to cardiac morphology and left ventricular diastolic and systolic functions were compared before and after parturition in 32 patients with PIH and 24 normal pregnant (NP) women. RESULTS: Compared with NP women, the PIH patients had greater diameters of left atrium and left ventricle in end-diastole (LAd: 38.9 +/- 4.5 vs 34.6 +/- 4.4 mm, P = 0.0015; LVEDd: 51.2 +/- 5.8 vs 47.1 +/- 4.2 mm, P = 0.036) and lower E/A (1.2 +/- 0.2 vs 1.4 +/- 0.2, P = 0.009) and greater fractional shortening (FS) (39.8 +/- 6.5% vs 37.1 +/- 6.9%, P = 0.042) and ejection fraction (EF) (0.72 +/- 0.07 vs 0.66 +/- 0.08, P = 0.040). Pericardial effusion (PE) occurred in 31.3% and 16.7% of PIH and NP, respectively. The LAd and LVEDd in 70% and 47% patients with PIH resolved and PE disappeared in 80% of PIH patients postpartum. E/A ratio in PIH significantly increased after parturition, while the two patients with cardiac systolic dysfunction did not improve very much. CONCLUSIONS: Compared with normal pregnancy, the most significant cardiac morphological changes in PIH are the greater diameters of left atrium and left ventricle, thicker inter-ventricular septum (IVS), more PE, impaired left ventricular diastolic function, and increased systolic function. The PE could disappear in PIH and about half of other abnormalities could recover to be the level of normal pregnancy postpartum within 2 months.