Can echocardiographic assessment of pathophysiology in gestational hypertension give a clue for diagnosing peripartum cardiomyopathy?

摘要

Hemodynamic changes during pregnancy are profound and begin even early in the first trimester. The plasma volume begins to increase in the 6~th week of pregnancy, and by the second trimester is approaches approximately 50% above baseline volume, but then plateaus until delivery. The heart rate also increases to about 20% above baseline, resulting in an increase in cardiac output by 30% at the end of the second trimester. Uterine blood flow increases with placental growth, and there is a fall in peripheral resistance, which may result in a slight fall in blood pressure (BP), also beginning in the first trimester. On the other hand, venous pressure in the lower extremities increases and leads to the common pedal edema that can develop in any healthy pregnant woman. Importantly, these dramatic changes only occur during a limited period of time.