Assessment of Clinical and Echocardiographic Findings of Pregnant Women with Dyspnea

Abstract

Objective: To measure the frequency of dyspnea in pregnant patients and to evaluate the clinical and echocardiographic findings of pregnant women had dyspnea.

Study Design: Analytical descriptive cross-sectional.

Place and duration of study: Gynae and Obstetric Department of Tertiary Care Facility from Feb 2022 to Apr 2022.

Methodology: It was an analytical cross sectional study conducted during three months. Consecutive pregnant females through non-probability consecutive sampling were included in the study. Patients who had diagnosed history of cardiac disease, respiratory illness, anemic and had covid-19 infection history of 3 months were excluded. The calculated sample size was 323. The pregnant females were assessed for dyspnea (shortness of breath) during pregnancy. Those patients who had dyspnea were referred to cardiac facility for 2D-ECHO (Echocardiography) to determine the cause of dyspnea. Frequency & percentage and mean ± SD were calculated for qualitative and quantitative data respectively. Chi square test was applied to find association between categorical variables. Student t-test was applied for continuous data.

Results:A total of 323 pregnant females of age more than 18 years were included in the study. Out of 87(26.9%) pregnant females who had dyspnea during their pregnancy, 2(2.1%) females were from 1st trimester, 26(23.2%) of 2nd trimester and 59(50.8%) of 3rd trimester. ECHO showed that mean left ventricle end-diastolic diameter (LVEDd) was 46±8mm, LVEF 58.8±7%, sPAP 25.40±3.5mmHg and LVESd 29.33±8.8mm. As compared to the normal range sPAP, LVESd were in lower range, while LVEDd value was higher than the normal range (27.2 mm). Study population who had dyspnea and hypertension (HTN) were (n=13)15.4% (p=1.000) and (n=7)7.7% were had Diabetes (DM) (p=1.000). Cardiac disease was found to be higher in females who had dyspnea i.e.(n=67) 76.9% (p=<0.0001)

Conclusion: The left ventricular end-diastolic diameter (LVEDd), left ventricle end-systolic diameter (LVESd), and systolic pulmonary artery pressure (sPAP) of pregnant women with dyspnea were all outside of the normal range. So that the cardiac causes of dyspnea can be clinically identified, we advise ladies with dyspnea to visit a cardiologist and have an echocardiography test.