European Journal of Cardiovascular Medicine

Background: Pregnancy is associated with volume overload producing significant vascular and hemodynamic adaptations  in cardiovascular physiology. Present study was designed to follow up  gradual adaptations in cardiovascular  hemodynamics  during the course of pregnancy using Doppler  echocardiography which is reproducible and noninvasive technique Method: In present  prospective study of 120 women, were divided into 2 groups of 60 each: control group & study group (pregnant patient in I trimester, II trimester & III trimester).  They were  non invasively  analysed for cardiovascular function and systemic hemodynamics using  echocardiography  and compared  with control group. The data was  analysed using ANOVA for comparison within the group and student’s t- test  for comparison between the groups. ‘p’- value < 0.05 was considered to be significant. Results:  Mean age and height  in control and study  groups  were comparable. Weight gain was within the expected range with advancement of pregnancy. Heart rate was increased in I and II trimesters with  peak rise in III trimester. The difference between control group and study groups was statistically significant (p < 0.05). Systolic blood pressure was slightly decreased in all the trimesters as compared to control group which was statistically not significant. There was gradual increase in SBP from I to III trimesters. Diastolic blood pressure progressively decreased in I and II  trimesters and then  increased in III  trimester. The difference in DBP between control group and I , II  trimesters of pregnancy was  significant (p<0.05). Systemic vascular resistance progressively  decreased  with advancement of pregnancy and difference was statistically significant (p <0.05) . Cardiac output is steadily  increased in all trimesters of pregnancy with peak at 36 weeks  and was statistically significant (p<0.05). It was due to increase in  both heart rate and Stroke volume. Ejection fraction also increased in all trimesters .Conclusions: Present  study shows  significant  functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be  introduced into the antenatal management protocol, which will help to identify women at high risk to developing  cardiovascular complications and there by  early intervention.