Maternal Myocardial Performance in Second Trimester of Pregnancy With Iron Deficiency Anaemia

Anaemia affects various organs in body including the heart. In anaemia, oxygen carrying capacity of blood decreases. Iron depletion and the amount of stored iron are reduced in iron deficiency anaemia which limits red cell production. However, the studies which show the effect of anaemia on myocardial function during pregnancy are few in India.

To study the effect of iron deficiency anaemia on myocardial function by ECG during second trimester of pregnancy and to compare ECG changes with normal pregnant women in second trimester.

The study was conducted at antenatal OPD between Oct 2014 to Jul 2015. Hundred pregnant women were selected and divided into 2 groups. A total of 50 normal pregnant women (control group) in 2(nd) trimester (10-14 weeks of gestation) were compared with equal number of pregnant women with anaemia (study group) in 2(nd) trimester, aged between 20-30 years. Electrocardiogram was recorded using Philips twelve channel ECG machine model TC20 in both control and study groups to evaluate myocardial performance. Haematological parameters were analysed by SYSMEX auto analyser. Analysis of Variance (One way ANOVA) was used for comparison between study and control groups and the data was analysed by t-tests.

In our study a significant decrease in QRS duration and increase in QTc were observed in study group (p<0.05). T-wave abnormalities like flat and negative T-waves in lead II, III, avF, V2 - V4 were more frequent (p<0.05). 90% of subjects in study group had tachycardia and ECG abnormalities. There was a negative correlation between Hb level, serum ferritin and tachycardia, ECG abnormalities.

Pregnancy with Iron deficiency anaemia brings about various changes in ECG, suggesting that anaemia and volume overload in pregnancy is a risk factor that may lead to cardiac hypertrophy.