Ultrasound findings on a correlation between placental function and maternal cardiac function during preeclampsia

Hypertensive disorders in pregnancy (HDP) have a direct impact on placental function. However, the relationship between placental function and maternal cardiac function in HDP patients is not well understood. The main objective of this study was to assess if a correlation exists between placental function and maternal cardiac function in women with pre-eclampsia. This study enrolled 148 pregnant women in their 2nd and 3rd trimesters (74 normotensive and 74 preeclamptic). We performed obstetric ultrasounds to assess these umbilical artery Doppler indices, namely the Resistive Index (RI) and Systolic and Diastolic (S/D) ratios. Transthoracic echocardiography was conducted on the participating mothers to evaluate chamber dimensions, wall thickness, and systolic and diastolic functions. The assessed systolic and diastolic function parameters included ejection fraction (EF), E/A ratio, and E/E’. Significant differences were observed between the two groups in parameters such as left ventricular dimensions (LVDd, IVSd, PWd, LVMI, LAD, AoR), diastolic function (E, A, E/A ratio), and placental indices (RI, S/D ratio). The ejection fraction was not significantly different between the two groups. In accounting for overall geometric remodelling, left ventricular hypertrophy (LVH) was exclusive to the pre-eclamptic group, with 4% exhibiting concentric and 19% eccentric hypertrophy. Concentric remodelling was observed in 20% of the preeclamptic group and 23% of the normotensive group. 77% and 57% of participants did not experience any form of remodelling in the normal and pre-eclamptic groups, respectively. Furthermore, the maternal left ventricular systolic and diastolic function parameters (EF, E/A ratio and E/E’ ratio) correlated with placental function indices (RI and S/D ratios), suggesting an interplay between maternal cardiovascular adaptation and placental perfusion abnormalities in preeclampsia. The study establishes a weak to moderate correlation between maternal diastolic and systolic function parameters and placental function indices (RI and S/D ratios) in preeclampsia. This supports the hypothesis that maternal cardiovascular maladaptation may contribute to placental dysfunction. Further studies are recommended to assess the persistence of cardiac remodelling postpartum. Clinicians might now consider more comprehensive cardiac assessments during prenatal care for patients at risk of preeclampsia. Monitoring maternal cardiac function could provide earlier insights into potential placental complications.