The efficacy of peripartum transthoracic echocardiography in women with preeclampsia

To examine the features and efficacy of transthoracic echocardiography (TTE) in preeclampsia.

We retrospectively reviewed the medical records of 145 pregnant women with preeclampsia, who underwent TTE at Seoul St. Mary's Hospital between July 2006 and June 2016. We analyzed echocardiographic features in preeclampsia and the relationship between the severity of preeclampsia and TTE findings. Additionally, we examined the predictive echocardiographic factors of persistent hypertension and calculated the adjusted odds ratio (OR) and 95% confidence interval (CI) for multiple regression models by considering systolic and diastolic blood pressure and pre-pregnancy body mass index (BMI).

Hemodynamic findings assessed by TTE in women with preeclampsia included systolic and diastolic dysfunction, increased left ventricular mass, and enlarged left atrium. Diastolic dysfunction and left ventricular hypertrophy (LVH) were more common in preeclampsia with severe features (39.84% vs. 32.05%, p=0.010, and 21.79% vs. 8.96%, p=0.041, respectively). In the patients with systolic dysfunction, the adjusted OR for persistent hypertension was 17.41 (95% CI=2.83-107.20). The ORs for grade 1 and grade 2 diastolic dysfunction were 12.58 and 32.84, respectively (95% CI, 2.99-52.92 and 3.61-298.58, respectively). When LVH assessed by TTE was considered with diastolic dysfunction, the risk for persistent hypertension increased (OR 19.28; 95% CI-4.36-85.20).

TTE not only can reveal the severity of preeclampsia, but also can be a useful tool for the follow-up of persistent hypertension.