Routine Echo Unneeded in Hypertensives


RENO, NEV. — Half of all pregnant women with hypertension have abnormal findings on echocardiography, but these abnormal findings did not predict differences in pregnancy outcomes, according to a study of 87 hypertensive patients.

Although some pregnant women with hypertension will require echocardiograms because of their clinical symptoms, the study suggests that routine echocardiograms are not indicated in otherwise asymptomatic women, investigators wrote in a poster presented at the annual meeting of the Society for Maternal-Fetal Medicine.

The study involved 87 pregnant women with hypertension seen over a period of more than 5 years in a single specialty clinic. The women underwent echocardiography, typically before 20 weeks of gestation, said Julie A. Gainer, D.O., of the University of Texas Southwestern Medical Center in Dallas, and associates.

Forty of the women (46%) had normal findings on echocardiography, and 47 (54%) had at least one abnormal finding. The most common abnormalities were concentric left ventricular hypertrophy, seen in 21 (24%) of the women; concentric left ventricular hypertrophy with a dilated left atrium, seen in 11 (13%) of the women; and dilated left atrium, seen in 12 (14%) of the women.

A comparison of women who had normal echocardiography results with those who had at least one abnormal finding revealed no significant differences in any measure.

The groups did not differ in any demographic variable, nor did they differ significantly in any of 10 measured pregnancy outcomes. These outcomes included the estimated gestational age at delivery, the proportion of women undergoing vaginal or cesarean delivery, the proportion with superimposed preeclampsia, and the length of their hospital stays.

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