Pre-Eclampsia

Pre-eclampsia is a potentially dangerous condition characterize; by high blood pressure that arises in some pregnant women; but a review of publish studies indicates that its effects on cardiovascular health can persist well after pregnancy. Pre‐eclampsia is a disease of pregnancy characterize by the manifestations of multi‐organ dysfunction.

Buthe recent use of transthoracic echocardiography in the assessment of women with pre‐eclampsia; has allowed the detection of cardiac systolic and diastolic dysfunction in the acute phase. It is a leading cause of maternal mortality; especially in developing countries, and affects 28% of all pregnancies.

Women with a history of pre‐eclampsia

Women with a history of pre‐eclampsia also have increase lifelong risks of cardiovascular disease; and mortality that persists well beyond the post‐partum period. These developments raise the possibility that pre‐eclampsia may be an early marker of cardiovascular disease; and the potential role for echocardiography in guiding the detection and management of this.  This review aims to summarise the existing evidence of echocardiographic cardiac assessment of women; with a history of pre‐eclampsia perform more than 12 weeks post‐partum.

However, systematic search of PubMed and OVID EMBASE databases was use; to identify studies featuring assessment of cardiac function perform after 12 weeks post‐partum in women with a history of pre‐eclampsia. Studies without post‐partum cardiac assessment; or with other document causes for cardiomyopathy were exclude.

Thirteen studies is found that measure cardiac function by transthoracic echocardiography; between 6 months and 18 years following a pregnancy complicated by pre‐eclampsia. But common findings across the studies were of increase diastolic dysfunction; increase left ventricular mass index (LVMI) and concentric hypertrophy in women with a history of pre‐eclampsia; as compare to women with uncomplicated pregnancy histories.

Progression of heart failure

But his is predominantly seen in those with a history of early or preterm pre‐eclampsia.  Studies are need to determine whether long-term cardiovascular screening might benefit women with a history of pre-eclampsia. Women with a history of early or preterm pre‐eclampsia have an increased prevalence of diastolic dysfunction.

However, this review demonstrates that the cardiac dysfunction associated with previous pre‐eclampsia is quantifiable and persistent. Progression of heart failure from asymptomatic to symptomatic stages carries a five fold increase in mortality. But the use of echocardiography could detect cardiac dysfunction in the asymptomatic stage and guide more intensive risk factor modification in these women.

“Pre-eclampsia is a real-life ‘stress test’ and the use of transthoracic echocardiography could help us detect early consequences on the heart before women experience symptoms,” said co-author Archana Selvakumar Thayaparan, MbChb, of Western Health, in Australia.