Electrocardiographic findings in women with a recent history of pre-eclampsia

Abstract

Objective: To assess the prevalence of electrocardiographic (ECG) abnormalities after a pregnancy complicated by pre-eclampsia and/or syndrome of hemolysis, elevated liver enzymes and low platelets (PE) and to compare the ECG characteristics, at least six months after pregnancy, between primiparous early-onset PE women with and without recurrent PE.

Design: Longitudinal observational study.

Setting: Tertiary referral centre in The Netherlands from 1996 to 2008.

Sample: Six hundred and fifty-eight formerly pre-eclamptic women. For our second objective, we used a subgroup of 79 primiparae with a history of early-onset PE.

Methods: Data were obtained during a postpartum screening program for women with hypertensive disorders during pregnancy.

Main outcome measures: Electrocardiographic abnormalities in PE women and characteristics of the ECG in women with recurrent PE after a first pregnancy complicated by early-onset PE.

Results: The ECG of 13 (2.0%), two (0.3%) and two (0.3%) former patients suggested ischemia, left ventricular hypertrophy and left atrial enlargement, respectively. Primiparae with recurrent PE in their second pregnancy differed from their counterparts with an uneventful second pregnancy by a leftward deviation of both the P- and the R-axes of 11° (p= 0.022) and 12° (p= 0.021), respectively, with a prolonged QT interval (p= 0.025).

Conclusions: The prevalence of ECG abnormalities in women with a recent history of PE was low and did not differ appreciably from that in a large population of healthy women of comparable age. The ECGs in primiparae with a history of early-onset PE who developed recurrent PE in their second pregnancy differed slightly from women with an uneventful second pregnancy, probably related to potential confounders.