The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

Abstract

Objective: To assess the effects of various stages of pregnancy as well as pregnant women age on the level of pulmonary artery systolic pressure. Methods: One hundred and thirty five healthy pregnant women, aged 18 to 42 years, were included in this study. They underwent voluntary transthoracic echocardiogram measurements of pulmonary artery systolic pressure at rest. Three groups of pregnant women were designed according to gestational age; Group 1 included pregnancies less than 13 weeks of gestation and considered as control group. Group II included pregnancies equal to 13 weeks gestation and less than 28 weeks. Group III included those pregnancies with 28 weeks of gestation up to term. Each group included 45 women. The mean pulmonary artery systolic pressure was calculated for each group. Results for groups two and three were compared separately to the control group. The study population was then regrouped according to women's age; Group A included women aged less than 35 years (n=95), Group B included women aged 35 years and above (n=40). Difference in mean pulmonary artery systolic pressure between groups A and B were studied. Results: Lower and upper limits of pulmonary artery systolic pressure during pregnancy were found to be 14 and 45 mmHg. Pulmonary artery systolic pressure during pregnancy showed an increase with maternal age after 35. Marginal change was also noted with gestational age; however that was of no statistical significance. Conclusion: During the different stages of pregnancy, mean pulmonary artery systolic pressure does not alter; however, it may reach high values in healthy asymptomatic women. When interpreting pulmonary artery systolic pressure in pregnancy, age correction may be required since pulmonary artery systolic pressure is found to physiologically increase with increasing pregnant women's age.

Correlation of echocardiographic probability of pulmonary hypertension with maternal outcomes in pregnant women with elevated right ventricular systolic pressure

“…Estimated RVSP on echocardiography has two components: TRV and RAP, the latter estimated by inferior vena cava diameter and collapsibility 7 . The upper limit of normal in the general population is an RVSP of 35 mmHg, 7 and while most women have a normal RVSP during pregnancy, 11 44 mmHg has been reported as the upper limit of normal in pregnant women 12 . Though assessment of the RAP by inferior vena cava diameter has been described in pregnant women, 13 the accuracy of this approach in any population is controversial 7,14 .…”

“…7 The upper limit of normal in the general population is an RVSP of 35 mmHg, 7 and while most women have a normal RVSP during pregnancy, 11 44 mmHg has been reported as the upper limit of normal in pregnant women. 12 Though assessment of the RAP by inferior vena cava diameter has been described in pregnant women, 13 the accuracy of this approach in any population is controversial. 7,14 In our study, RAP was not different between cohorts; however, over-estimation likely occurred in the LP cohort leading to elevated RVSP.…”