Publication:

Electrocardiographic pattern in hypertensive disorders of pregnancy

Background Hypertensive disorders of pregnancy are a major cause of poor pregnancy outcome and complicate ~6-11% of all pregnancies. When diagnosed during pregnancy, hypertension disorders escalate the maternal risk of placental abruption, cerebrovascular accident and disseminated intravascular coagulation, as well as fetal risk of intrauterine growth restriction, intrauterine death and prematurity. Interpretation of the ECG is an important component in the assessment of cardiovascular adaptations during pregnancy.

Methods In this study, 105 pregnant women (gestational age >20 weeks) with hypertensive disorders of pregnancy (HDP) in the range of 18 to 45 years of age were recruited and compared with the equal number of age matched normotensive pregnant women. ECG parameters were compared with those of normotensive pregnant women.

Results There was left axis deviation in 28.6% in HDP group as compared to 10.5% in control group, while as 71.4% and 84.8% had normal axis in HDP and control group respectively, 4.85% in control group had right axis deviation there was statistical significant difference between the two (p<0.05). There was statistically significant difference between the two groups in ECG characteristics of T wave flattening or inversion in lead III, T wave in lead V1, V2 and V3, (p<0.05). The mean QTc interval was found to be 440.28±43.62 msec in HDP women and 417.42±21.74 msec in normotensive control pregnant women and there was statistically significant difference between the two groups (p=0.000).

Conclusions ECG abnormalities seen in patients with hypertensive disorders of pregnancy (HDP) include left axis deviation, T wave abnormalities, an alteration of ventricular repolarization as evidenced by prolongation of ECG parameters, such as QTc.