Abstract:
BACKGROUND : Pre-eclampsia is associated with significant
changes to the cardiovascular system during pregnancy.
Eccentric and concentric remodelling of the left ventricle
occurs, resulting in impaired contractility and diastolic
dysfunction. It is unclear whether these structural and functional
changes resolve completely after delivery.
AIMS : The objective of the study was to determine cardiac
diastolic function at delivery and one year post-partum in
women with severe pre-eclampsia, and to determine possible
future cardiovascular risk.
METHODS : This was a descriptive study performed at Steve
Biko Academic Hospital, a tertiary referral hospital in
Pretoria, South Africa. Ninety-six women with severe preeclampsia
and 45 normotensive women with uncomplicated
pregnancies were recruited during the delivery admission.
Seventy-four (77.1%) women in the pre-eclamptic group were
classified as a maternal near miss. Transthoracic Doppler
echocardiography was performed at delivery and one year
post-partum.
RESULTS : At one year post-partum, women with pre-eclampsia
had a higher diastolic blood pressure (p = 0.001) and body
mass index (p = 0.02) than women in the normotensive
control group. Women with early onset pre-eclampsia requiring
delivery prior to 34 weeks’ gestation had an increased
risk of diastolic dysfunction at one year post-partum (RR
3.41, 95% CI: 1.11–10.5, p = 0.04) and this was irrespective of
whether the patient had chronic hypertension or not.
CONCLUSION : Women who develop early-onset pre-eclampsia
requiring delivery before 34 weeks are at a significant risk
of developing cardiac diastolic dysfunction one year after
delivery compared to normotensive women with a history of
a low-risk pregnancy.
