ABSTRACT

Preeclampsia is an important cause of maternal and fetal mortality and morbidity worldwide. P-wave dispersion (P_d) and QT interval dispersion (QT_d) are direct measures of the nonhomogenity of atrial depolarization and ventricular repolarization, respectively, in electrocardiography (ECG). Recent studies have reported a significant role of prolonged P_d and QT_d in various cardiovascular diseases. Because the effect of acute pressure overload, which occurs in a preeclamptic setting, on the intra- and/or interatrial and ventricular conduction times remains unknown, we aimed to investigate the relation of P_d and QT_d with the presence and severity of preeclampsia.

Forty-eight consecutive pregnant women with preeclampsia and 55 healthy, age-matched pregnant women were included in this retrospective study between January and September 2015. The pregnant women with preeclampsia were divided into two groups according to disease severity as follows: mild and severe preeclampsia. A 12-lead ECG was performed for all the pregnant women before cesarean section operation.

Compared with the healthy pregnant women, P_d and QT_d were significantly prolonged in patients with preeclampsia. Moreover, in the subgroups of preeclampsia, P_d was significantly increased in the severe group. P_d and QT_d were directly related to systolic and diastolic blood pressure, which are well-known validated indicators for the severity of preeclampsia.

Preeclampsia triggers an alteration of atrial depolarization and ventricular repolarization, which are evidenced by the prolongation of ECG parameters such as P_d and QT_d. ECG is a noninvasive, easy to use, and easily available diagnostic tool, which can be used in the assessment of atrial and ventricular electrical activity in pregnant women with preeclampsia.

Keywords: Preeclampsia, P-wave dispersion, QT dispersion, electrocardiography