title: Abnormal maternal echocardiographic findings in triplet pregnancies presenting with dyspnoea.
abstract: OBJECTIVE
  The objective of our study was to evaluate the prevalence of abnormal maternal echocardiographic findings in triplet pregnancies presenting with dyspnoea.
  
  
  METHODS
  Between 2003 and 2013, patients' records of 96 triplet pregnancies at our department were analysed including maternal and fetal outcome, echocardiographic parameters and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. After exclusion of triplet pregnancies with fetal demise before 23 + 0 weeks, selective feticide or missing outcome data, the study population consisted of 60 triplet pregnancies. All women with dyspnoea underwent echocardiography and measurement of NT-proBNP.
  
  
  RESULTS
  Dyspnoea towards the end of pregnancy was observed in 13.3% (8/60) of all women with triplet pregnancies, and all of these women underwent echocardiography. The prevalence of abnormal echocardiographic findings in women with dyspnoea was 37.5% (3/8) with peripartum cardiomyopathy in one woman. Median serum NT-proBNP was significantly higher in women with abnormal echocardiographic findings compared with those without (1779 ng/ml, range 1045-6076 ng/ml vs 172 ng/ml, range 50-311 ng/ml; p < 0.001 by Mann-Whitney-U Test).
  
  
  CONCLUSIONS
  We conclude that triplet pregnancies presenting with dyspnoea show a high prevalence of abnormal echocardiographic findings. Since dyspnoea is a common sign in triplet pregnancies and is associated with a high rate of cardiac involvement, echocardiography and evaluation of maternal NT-proBNP could be considered to improve early diagnosis and perinatal management.
authors.affiliation: Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Marie
authors.initials: M
authors.lastname: Elhenicky
authors.affiliation: Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Distelmaier
authors.affiliation: Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Mariella
authors.initials: M
authors.lastname: Mailath-Pokorny
authors.affiliation: Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Christof
authors.initials: C
authors.lastname: Worda
authors.affiliation: Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Langer
authors.affiliation: Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. katharina.worda@meduniwien.ac.at.
authors.forename: Katharina
authors.initials: K
authors.lastname: Worda
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology*; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D059286:Pregnancy, Triplet / Q000097:blood / Q000706:statistics & numerical data*; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Dyspnoea in pregnancy; Maternal echocardiography; Multiple pregnancy; Pro-B-type natriuretic peptide; Triplet pregnancy