Screening and localization of silent pericardial effusion in healthy pregnant women

Abstract

During normal pregnancy, the functional load on the heart and circulation are monitored, but the effect of pregnancy on the pericardium has not received the deserved attention. The aim of this study was to assess pericardial sac during normal pregnancy when developing pericardial effusion, with reference to clinical significance and prognostic signs. One hundred and four asymptomatic healthy pregnant women were clinically examined and investigated by M-mode and two-dimensional echocardiography at 12th, 24th and 36th weeks' gestation and in the 8th week after delivery. The findings were compared with those from 50 young age-matched non-pregnant women with no heart diseases. Pericardial effusion of different severity was detected in 24 cases (23 %). The size of the effusion was assessed by a simple method based on volume estimation of a prolate ellipse derived from the measurement of the length and two minor axes of the ellipse which is used to estimate total pericardial sac volume and cardiac volume. The pericardial fluid volume is the difference between these two volumes. The effusion was large in 4 (3.8 %), moderate in 4 (3.8 %) and small in 16 (IS%) cases. Eight weeks after delivery, there was little or no evidence of pericardial effusion in the 16 cases of small effusion, but there was a major reduction in the size of effusion in the eight cases, with a large and moderate pericardial fluid formula.