Cardiovascular Complications in Pre-eclampsia: Can they be Predicted Electrocardiographically?

Abstract

Background: Pre-eclampsia is a common condition that causes significant morbidity and mortality in pregnant women; the occurrence of cardiovascular complications aggravates the disease. Efforts have been made to predict the complications of pre-eclampsia, but some modalities, such as echocardiography and biomarkers, are neither available nor widely feasible for use by healthcare providers, especially in developing countries. On the other hand, ECG is cheap, noninvasive, widely available, and already routinely performed for pre-eclampsia. The role of ECG in predicting cardiovascular complications in pre-eclampsia patients is not known. Objective: This study aimed to investigate the role of ECG in pre-eclampsia diagnostics and simple clinical parameters in pre-eclampsia patients with and without cardiovascular complications. Methods: This cross-sectional, analytical study used retrospective data from medical records of patients with pre-eclampsia from the Dr Kariadi General Hospital, Semarang, Indonesia, from January 2016–July 2017. Bivariate association between demographic, clinical, laboratory, and ECG results with the occurrence of cardiovascular complications was tested; this continued with logistic regression. Results: Sixty-eight pre-eclampsia patients were identified, with a mean age of 30.2 years. Cardiovascular complications occurred in 16 patients (23.5%), with 14 patients exhibiting pulmonary oedema. In univariate analysis, haemoglobin level and heart rate showed a significant association with the occurrence of cardiovascular complications (p=0.035 and 0.033, respectively). No significant independent predictor was found in multivariate analysis. Conclusion: This study showed that ECG parameters were not able to predict cardiovascular complications in pre-eclampsia patients. Nevertheless, there was a significant association between heart rate and haemoglobin level with cardiovascular complications in pre-eclampsia.