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Wiley InterScience

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 103 Issue 6, Pages 523 - 528

Published Online: 19 Aug 2005

Journal compilation © 2010 RCOG



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Cardiac abnormalities in pulmonary oedema associated with hypertensive crises in pregnancy
D. K. Desai Consultant 1 , J. Moodley Professor 1 , D. P. Naidoo Consultant 1 , I. Bhorat Senior Registrar 1
  1 MRCI UN Pregnancy Hypertension Research Unit, Faculty of Medicine, University of Natal, Durban, South Africa
  Correspondence: Professor J. Moodley, MRC/UN Pregnancy Hypertension Research Unit, Faculty of Medicine, University of Natal, Po Box 17039, Congella, 4013, South Africa.
Copyright RCOG 1996 British Journal of Obstetrics and Gynaecology

ABSTRACT

Objective To describe the cardiac abnormalities by two-dimensional and Doppler echo-cardiography (echo-Doppler) in hypertensive crises in pregnancy (HCP) complicated by pulmonary oedema and identify pathogenic factors.

Design A prospective observational study.

Setting King Edward VIII Hospital, Durban, South Africa.

Participants Sixteen patients with HCP complicated by pulmonary oedema over a six-month period. Two control groups, 55 patients with HCP alone and 16 with normotensive pregnancies, were also studied.

Results Echocardiography diagnosed impaired left ventricular systolic function in 4 of 16 (25 %) patients with HCP and pulmonary oedema. In the remaining 12 patients with preserved systolic function, left ventricular diastolic filling abnormalities were demonstrated in a significant proportion compared to control hypertensive and normotensive groups. Fifteen of 16 (94%) study patients presented with pulmonary oedema antepartum; in seven of these patients, the use of dexamethasone to enhance fetal lung maturity appeared to be a contributing factor in precipitating pulmonary oedema.

Conclusion This study demonstrates the value of echo-Doppler to diagnose structural and functional cardiac abnormalities in HCP complicated by pulmonary oedema. The potential role of left ventricular diastolic filling abnormalities in the pathogenesis of pulmonary oedema complicating HCP is discussed.


Received 6 March 1995 Returned for Revision 20 July 1995 Revised Manuscript Received 20 September 1995 Accepted 23 October 1995

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1471-0528.1996.tb09800.x About DOI

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