LAUSR

Introduction Acute pulmonary oedema remains a life threatening complication of pre-eclampsia. The systolic left ventricular function in patients with pre-eclampsia and pulmonary oedema is not clear. Hypothesis We hypothesise that pulmonary oedema complicating pre-eclampsia is associated with the presence of a higher incidence of LV systolic dysfunction compared to LV function in patients with pre-eclamspia without pulmonary oedema. Methods Obstetric patients admitted to the Obstetric Critical Care Unit at Tygerberg Academic Hospital with pre- eclampsia complicated by pulmonary oedema were prospectively studied. The study design was a prospective case control study. Patients admitted during February 2016 and February 2017 with pre-eclampsia and pulmonary oedema, pre-eclampsia without pulmonary oedema and a normal control group were prospectively enrolled. An echocardiogram was performed on all the groups. LV function was mainly assessed by the LV ejection fraction (LVEF) estimation by the Teicholz and Biplane method and the lateral S wave tissue. Mean differences in the pre-eclampsia groups were compared to the normal control group. The primary objective was to compare the left ventricular systolic dysfunction function. Ethics permission was obtained and the statistical analysis was performed by the Biostatistics Unit of the University of Stellenbosch. Results Twenty-one patients with pre-eclampsia and pulmonary oedema, 21 pre-eclampsia patients without pulmonary oedema and 21 normal patients were included in the study. The mean percentage difference in terms of lateral tissue doppler S wave displacement was calculated as follows: 19% lower in the patients with pulmonary oedema and 5 % lower in the pre-eclampsia patients compared to the normal control group ( p = 0.31) Diastolic dysfunction was present in 48% of patients with pulmonary oedema compared to 33% of the control group without pulmonary oedema (p = 0.12) Conclusions Blood pressure control and afterload reduction remains one of the most important measures in the management of pre-eclamptic patients with or without pulmonary oedema.