Echo Doppler Assessment of Autonomic Dysfunctions in Second Trimester of Pregnancy
Journal Title: National Journal of Integrated Research in Medicine - Year 2010, Vol 1, Issue 1
Abstract
For the present study subjects were randomly selected from the females in the age group of 20 – 30 years with the singleton mid-term pregnancy (20 -28 weeks) attending antenatal clinics of New Civil Hospital, Surat. The control group comprised of purposive sample (33 healthy subjects) selected from those attending other outpatient department in reference to comparable age, height & accessibility. The subjects were asked to perform valsalva manoeuvre by forcibly exhaling in an aneroid pressure measuring device (manometer) & maintain a pressure of 40 mmHg for 15 seconds or less formally the patient may be asked to bear down as if having a bowel movement. It is used as a diagnostic tool to evaluate the condition of the heart. Echocardiography was recorded using MEGAS CVX & MEGAS GPX equipped with ADV4 software from ESAOTE s.p.a Firenze, Italy. For Doppler echocardiography the frequency used was 2.0 -2.5 – 3.3 -5.0 MHZ & sweep time was 2 – 12 seconds. Our observations suggests that volume overload during pregnancy is a risk factor for left ventricular contractility functions. Increased values of stroke volume, cardiac output & cardiac index interpret the result of inability to compensate pressure overload or elevated venous return. Left ventricular diastolic dysfunction in the form of relaxation abnormalities is one of the first changes with left ventricular hypertrophy. In our study sample the pregnant females after performing valsalva manoeuvre decreased mean E/A ratio was observed compared to the non pregnant females. It has been suggested that changes in the left atrial pressure may mask or mimic left ventricular diastolic function abnormalities detected by Doppler echocardiography. The valsalva manoeuvre could help better to account for the effect of left atrial pressure on the transmitral flow velocity profile & differentiate between subjects with or without LV diastolic function abnormalities.
Authors and Affiliations
Dr. D. V. Thakker*, Dr. V. B. Kariya**, Dr. Amalkumar Bhattacharya
Keywords
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