Second trimester cardiac output and its predictive value for preeclampsia

To predict women at risk of preeclampsia in the second trimester by the assessment of maternal cardiac output (CO).

Between October 2001 to November 2003, we carried out a cross-sectional, prospective, hospital-base study in Shiraz University of Medical Sciences, Shiraz, Iran. Cardiac output was measured in 102 normotensive women at gestational age 19-25 weeks by Doppler echocardiography. Patients with CO >7.4 L/min were considered high risk group (Group 1) and those with CO < or =7.4 L/min were in Group II. They were followed-up until delivery and the incidence of preeclampsia was determined in both groups.

Twenty percent (6/30) of patient in Group 1, and 1.4% of patients in group II developed preeclampsia (p < 0.003). A cut off point of 7.34% L/min was chosen for prediction of preeclampsia that showed 85.7% sensitivity, 74.2% specificity with a negative predictive value of 98% and positive predictive value of 20%.

Cardiac out put is significantly elevated in preclinical state of preeclampsia. Echocardiography is a non-invasive method to evaluate the maternal homodynamic during the second trimester and can help to identify high-risk patient before the development of preeclampsia, thereby it may improve the outcome of pregnancy.