Department of Anaesthesia, Royal Women's Hospital, Parkville, Australia.
Int J Obstet Anesth. 2012 Apr;21(2):129-34. doi: 10.1016/j.ijoa.2011.11.007. Epub 2012 Feb 11.
Obesity in pregnant women is a serious health issue. Invasive monitoring devices are rarely used in pregnancy due to their risks; however, assessment of cardiac function is often required in these women. Transthoracic echocardiography offers advantages but may be technically difficult to perform. Our aim was to determine the feasibility of transthoracic echocardiography and to quantify left ventricular function and structure using transthoracic echocardiography in obese pregnant women.
Fifteen obese but otherwise healthy pregnant women (body mass index >30 kg/m(2)), were compared with 40 healthy non-obese pregnant women. Echocardiography was performed according to American Society of Echocardiography recommendations.
Test completion with key haemodynamic data were obtained in 100% of women. Gestational age (Mean ± SD) was similar between groups (36 ± 5 weeks). Compared with non-obese pregnant women, obese pregnant women had elevated mean arterial pressure (88 ± 6 vs. 81 ± 8 mmHg, P=0.003), increased left ventricular mass (162.8 ± 35.4 vs. 130.8 ± 21.0 g, P=0.008) but similar cardiac output (4417 ± 890 vs. 4109 ± 595 mL/min, P=0.230) and diastolic changes (mitral valve E/se' > 8 in 33% vs. 15% of patients, P=0.26). Septal tissue Doppler indices in obese pregnant women were s' 9.1 ± 1.9 cm/s, e' 11.6 ± 2.6 cm/s, a' 8.1 ± 2.7 cm/s. Tei index was reduced in both groups (0.49 ± 0.12 vs. 0.42 ± 0.09, P=0.05).
Transthoracic echocardiography was used to delineate haemodynamics in obese pregnant women. Mean arterial blood pressure and left ventricular mass were increased in obese pregnant woman. The incidence of diastolic impairment and reduced myocardial performance were similar between groups.
孕妇肥胖是一个严重的健康问题。由于存在风险，侵入性监测设备在怀孕期间很少使用；然而，这些女性通常需要评估心功能。经胸超声心动图具有优势，但操作可能具有技术难度。我们的目的是确定经胸超声心动图在肥胖孕妇中的可行性，并使用经胸超声心动图定量评估左心室功能和结构。
将 15 名肥胖但健康的孕妇（BMI>30kg/m2）与 40 名健康非肥胖孕妇进行比较。超声心动图按照美国超声心动图学会的建议进行。
所有女性均成功完成检查并获得关键血流动力学数据。两组孕妇的孕周（均值±标准差）相似（36±5 周）。与非肥胖孕妇相比，肥胖孕妇的平均动脉压升高（88±6mmHg 比 81±8mmHg，P=0.003），左心室质量增加（162.8±35.4g 比 130.8±21.0g，P=0.008），但心输出量相似（4417±890mL/min 比 4109±595mL/min，P=0.230），舒张变化相似（二尖瓣瓣环运动速度 E/组织多普勒速度 e' > 8 的患者比例在两组中分别为 33%和 15%，P=0.26）。肥胖孕妇的室间隔组织多普勒指数为 s' 9.1±1.9cm/s、e' 11.6±2.6cm/s、a' 8.1±2.7cm/s。两组的 Tei 指数均降低（0.49±0.12 比 0.42±0.09，P=0.05）。
经胸超声心动图用于描绘肥胖孕妇的血液动力学。肥胖孕妇的平均动脉压和左心室质量增加。两组舒张功能障碍和心肌收缩功能降低的发生率相似。
