Evaluation of maternal myocardial performance during normal pregnancy and post partum

Little information exists about the use of noninvasive methods to characterized left ventricular mechanical adaptation during normal pregnancy. The aim of this study was to evaluate left ventricular performance during normal pregnancy and study the effect of maternal factors.

The study was conducted at Govt. Medical College and New Civil Hospital, Surat between February 2006 to March 2008. M-mode and Doppler echocardiography was performed in 31 normal pregnant women at 30-40 weeks and 8-12 weeks postpartum. Heart rate, stroke volume, cardiac output and left ventricular mass increased significantly, while total vascular resistance decreased significantly during last trimester of pregnancy. Left ventricular contractility indices (percentage ejection fraction and fraction shortening) were within normal limit during pregnancy but fractional shortening was significantly higher post-partum than in the last trimester of pregnancy (p < 0.05). Maternal age was related to the transmitral peak velocity of early filling (E, p = 0.001) and the E to A ratio (p < 0.001), while height was related to heart rate (p < 0.001), stroke volume (p = 0.003), cardiac output (p < 0.001) and left ventricular mass (<0.005).

This study express that along with gestation, maternal anthropometric profile may affect cardiac performance. Systolic performance was better in tall individuals and diastolic performance was better in younger individuals.