Screening Echocardiography in Morbidly Obese Pregnant Women

Objective: We sought to describe the echocardiographic findings of morbidly obese gravidas who had No history of underlying cardiac dysfunction.

Study design: We evaluated 27 morbidly obese pregnant patients between 16 and 35 weeks gestation. A single echocardiogram was obtained on each patient. Measurements of cardiac function and structure using echocardiogram data were compared across patient subgroups. Subgroups consisted of “healthy” obese patients (no diabetes or hypertension), those with pregnancy associated hypertension (gestational hypertension or preeclampsia), chronic hypertension, diabetes, or both (chronic hypertension and diabetes). Echocardiogram parameters were evaluated across each group and correlated with body mass index (BMI). Clinical outcomes were recorded. Nonparametric Spearman correlation tests were performed to evaluate these relationships.

Result: Left Ventricular Mass Index (LVMI) was significantly associated with BMI at enrollment (r=0.48, p=0.02). The posterior wall thickness (PW) was also associated with BMI at enrollment and delivery (r=0.44, p=0.03; r=0.47, p=0.02 respectively). These relationships remained significant after controlling for a history of hypertension.

Conclusion: Our data suggest that echocardiography performed solely on the basis of a BMI ≥ 40 can identify echocardiogram abnormalities in structure that could be important for future follow-up.

Keywords:Echocardiogram; Left ventricular hypertrophy; Obesity; Pregnancy