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Left ventricular concentric geometry as a risk factor in gestational hypertension
Gian Paolo Novelli1, Herbert Valensise, Barbara Vasapollo
1Semeiology and Medical Methodology, Tor Vergata University, Rome, Italy.
Hypertension (Dallas, Tex. : 1979)
|March 8, 2003
Summary
Altered left ventricular geometry in mild gestational hypertension predicts adverse pregnancy outcomes. Concentric geometry is a significant independent predictor, offering crucial prognostic information beyond blood pressure alone.
Area of Science:
- Cardiology
- Obstetrics
- Hypertensive Disorders of Pregnancy
Background:
- Altered left ventricular geometry is linked to poor prognosis in essential hypertension.
- Prognostic significance of cardiac structure changes during pregnancy remains unexamined.
Purpose of the Study:
- To assess the impact of altered left ventricular geometry on pregnancy outcomes in mild gestational hypertension.
Main Methods:
- 148 pregnant women with mild gestational hypertension (BP 140-150/90-99 mmHg) were monitored until term.
- Adverse outcomes included preeclampsia, preterm delivery, fetal distress, and neonatal complications.
Main Results:
- Concentric geometry was more common in patients with complicated pregnancies (78.7%) versus uneventful ones (30.1%).
- Multivariate analysis identified concentric geometry as an independent predictor of adverse outcomes (OR 3.65, P=0.014).
Conclusions:
- Blood pressure alone is insufficient for risk stratification in gestational hypertension.
- Left ventricular geometry provides additional prognostic value, potentially enhancing clinical management.