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


METHODS
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.
Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China King's College London, London, UK. cqshaoyong@yahoo.com.cn
Yong
Y
Shao
Ying-Hong
YH
Zhang
Ou Mamie
OM
Liu
D000328:Adult; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006347:Heart Sounds / Q000502:physiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D009200:Myocardial Contraction / Q000502:physiology*; D010701:Phonocardiography; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome