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Hemodynamic changes in normal indian primigravida: serial evaluation by echocardiography

Authors:Jyotsana R. Bharshanakar , Chaitali T. Kakade , Rajay N. Bharshankar Sunita D. Kumbhalkar , Ashok H. Kale
Int J Biol Med Res. 2012; 3(1): 1289-1293  |  PDF File

Abstract

Aim: To evaluate the hemodynamic changes in a normal Indian primigravida and to observe the onset, magnitude and recovery of these changes. Method: In a prospective study, 30 primigravid women were evaluated 4 times at early, mid and late gestation and at 6 weeks postpartum. At each visit, echocardiography was performed in the left lateral decubitus position to assess the hemodynamic changes. The data was subjected to statistical analysis to observe the changes at different gestational periods by using ANOVA. Results: Considering values of 6 weeks postpartum a baseline, the mean values of cardiac output (COP) increased in early gestational period (from 3.75±0.39 to 4.41±0.43 L/min, p<0.01). It continued to increase further in mid (4.95±0.5, p<0.001) and later gestational periods (5.57±0.56, p<0.001). Mean arterial pressure (MAP) was decreased in the early gestation (86.44±4.24 to 75.37±5.70 mm of Hg, p<0.001) and then increased. Total peripheral resistance (TPR) decreased in the early (1863.18±212 to1467.81±187,p<0.001), continued to decrease in mid gestation (1467.81±187 to 1228.09±115,p<0.001). Left ventricular mass increased gradually in early and mid gestation and the peak value was observed at late gestation. Ejection fraction and fractional shortening were same throughout pregnancy and at 6 weeks postpartum. Conclusion: The TPR and MAP decreases in the early, CO increases in the mid and later weeks of pregnancy. Left ventricular systolic functions were well preserved during pregnancy.