Pregnancy in accordance with study of Solanki et

Pregnancy is a condition of primary peripheral arterial
vasodilation, associated with hyperdynamic circulation with high CO and low SVR11
Preeclampsia
is a disease unique to pregnancy that contributes substantially to maternal and
fetal morbidity and mortality, and is associated with increased vascular
resistance and  hypertension12
Hypertension produces  structural changes
in the left ventricle usually accompanied by functional alterations and in  majority of cases, these alterations precede
clinical manifestations13 In normal pregnancy, an increased preload
and a decreased afterload favor an improved emptying of the left ventricle
during systole and a reduction of the end-systolic pressure14 In
preeclamptic women, the elevated afterload is linked with a reduced emptying of
the left ventricle and elevated end-systolic pressure. Rizwana Solanki et al found a
statistically significant difference in mean SV between pre eclamptics and
normotensive women groups studied5.

 

Results of present study 
were also comparable to study done by Dennis et al15 They observed  cardiac output  was higher in PIH group as compared to the
controls . They stated that cardiac output is increased in women with untreated
pre eclampsia due to an increase in stroke volume.

Solanki et al found cardiac output  was significantly higher in pre eclamptic
patients5 Our results were comparable to their. In present study ,
systemic vascular resistance was more in pre eclimptic  patients .This is in accordance with study of
Solanki et al5 .

 

1.      Conclusion

Doppler
echocardiography provides an excellent non-invasive method for the evaluation
and serial analysis of hemodynamic changes 
during pregnancy. They  help in
distinguishing abnormal  changes
from  maternal physiologic changes.

Preeclampsia still contributes to a
majority of maternal mortality and morbidity. Therefore echocardiography if introduced into the  antenatal protocol, could help to identify subset
of preeclamptic women
who are at high risk to develop cardiovascular complications and there by can
do early intervention.

Limitation: It was performed in a single hospital
therefore sample may not be representative of all Indian women. Therefore we
recommend a cross-sectional multicentric study to confirm results.

Future: Further studies can be made by 3D
echocardiography which is based on direct volumetric quantification, which is
independent of geometric assumption of Left Ventricle

Ethical approval: by Institutional Ethics Committee