Using phonocardiography to investigate maternal cardiac reserve function in gestational hypertension and pre-eclampsia

Authors

  • Yong Shao,

    Corresponding author
    1. Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
      Dr Yong Shao, Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. Email: cqshaoyong@yahoo.com.cn
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  • Ying-hong Zhang,

    1. Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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  • Ou Mamie Liu

    1. King's College London, London, UK
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Dr Yong Shao, Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. Email: cqshaoyong@yahoo.com.cn

Abstract

Aim:  This study used phonocardiography to investigate maternal cardiac reserve function in gestational hypertension and pre-eclampsia.

Method:  Ninety-nine pregnant women with gestational hypertension (50 cases) and pre-eclampsia (49 cases) were included in the study; 99 normotensive pregnant women acted as controls. Using phonocardiography, cardiac reserve function parameters for all participants were recorded: heart rate, the ratio of the first heart sound magnitude to the second heart sound magnitude (S1/S2) and the ratio of the diastolic duration to the systolic duration (D/S).

Results:  The average values for S1/S2 in the pre-eclampsia and gestational hypertension groups were 4.3 ± 2.2 and 2.2 ± 1.1 respectively. The average D/S of the pre-eclampsia and gestational hypertension groups were 1.1 ± 0.3 and 1.4 ± 0.3 respectively. Cases of postnatal adverse maternal outcomes were only observed in the pre-eclampsia group. A small proportion (2 out of 28) suffered cardiac-related complications, with one of these two patients dying from cardiac failure. Both these cases had notably poor cardiac reserve function (S1/S2 > 5.00 and D/S < 1) before delivery. The index S1/S2 increases and the index D/S decreases with increasing severity of hypertension-complicated pregnancies.

Conclusions:  Our findings indicate that cardiac reserve function declines with the increasing severity of hypertension during pregnancy. Phonocardiography is a useful, convenient and clinically worthwhile technique to monitor cardiac reserve function parameters of pregnant women with pre-eclampsia.

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