Cardiac abnormalities may help identify women at risk of recurrent pre-eclampsiaBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1089 (Published 23 February 2016) Cite this as: BMJ 2016;352:i1089
Doctors may be able to identify which women are at high risk of recurrent pre-eclampsia by using echocardiography to look for certain cardiovascular abnormalities between pregnancies, say researchers in the journal Hypertension.1
Previous research has shown that women who have had pre-eclampsia are seven times as likely as women who had normal pregnancies to develop pregnancy related high blood pressure in later pregnancies and to have cardiovascular disease in later life. However, it has not been clear how to predict who is at greatest risk for these complications.
The Italian case control study included 75 women with normal blood pressure who had previous pre-eclampsia and 147 controls with a previous uneventful pregnancy. The average age of the women at the start of the study was 34 years. The women all underwent echocardiography while not pregnant 12-18 months after they had delivered a first baby. All the women became pregnant again within two years and were followed until the end of their pregnancies.
Twenty two (29%) of the 75 women with previous pre-eclampsia developed it again during their next pregnancy. When compared with women who had never had pre-eclampsia or who had it once, these women had significantly lower stroke volume and cardiac output and elevated total vascular resistance values. Compared with controls, women who had recurrent pre-eclampsia had a left ventricle that was unusually thick and had to work harder while pumping significantly less blood.
Those women who had previous pre-eclampsia that did not recur in the second pregnancy had left ventricular structural and functional features that were intermediate between those in the control group and women who had recurrent pre-eclampsia, the researchers found.
The researchers acknowledged that this was a small study and that further research was needed to confirm their findings. Study author Herbert Valensise, associate professor of obstetrics and gynaecology at Tor Vergata University School of Medicine in Rome, said, “Women who have early pre-eclampsia in their first pregnancy should be informed of their risk and should be carefully followed.”