The Effect of Maternal Hypertension on Fetal Cardiac Function: Fetal Echocardiography Study

Background: Maternal hypertension may result in signifmaternal, fetal and neonatal morbidity and mortality. Aim: To investigate the effects of maternal hypertension with their complications on human fetal cardiac function. Methods: A prospective study including of 59 singleton pregnancies with hypertension (gestational age ranging from 22-30 weeks). The diagnosis of maternal hypertension was based on clinical criteria. We classified our cases into three groups, Group I, consisted of 38 preeclampatic, 14 pregnant women diagnosed with chronic hypertension in Group II, and Group III included 7 pregnant women diagnosed as pregnancy induced hypertension (PIH). Each group was subclassified into mild or severe form of hypertension. Umbilical artery indices were calculated (Resistance index (RI, S/D ratio), also complete fetal echocardiographic examination and Tei- index were calculated. The control group consisted of 25 normal singleton pregnancies. Results: Our results demonstrated that there were a highly significance in both S/D ratio and RI in mild preeclampsia (3.6±0.5 0.59±0.5 respectively) and in severe form of preeclampsia RI was 0.68±0.6 and S/D ratio was 4.2±0.6 both were statistical significant and in severe type of chronic hypertension (S/D ratio 5.0±0.4 RI 0.69±0.5). Global fetal cardiac dysfunction (both right and left ventricular dysfunc- tions) was found in severe form of pre-eclampsia (Tei index TI for left ventricular (LV) was 0.69±0.09, right ventricular (RV) was 0.76±0.05) and in severe type of chronic hypertension(TILV 0.74 ±0.7 TIR V 0.76±0.05). RV dysfunction was presented in mild pre-eclampsia (TI 0.56±0.06). Intrauterine growth retardation (IUGR) was found high significantly (p 0.0001) with severe preeclampsia (83%) and in severe chronic hypertension (100%). Conclusion: We concluded that maternal hypertension especially a severe form of preeclampsia and chronic hypertension had a significant global fetal cardiac dysfunction and statistical significant of umbilical artery indices. Recommondation: The clinical significance of the fetal cardiac disturbances with maternal hypertension must be addressed in future studies.