Abnormal maternal echocardiographic findings in triplet pregnancies presenting with dyspnoea.
OBJECTIVE
The objective of our study was to evaluate the prevalence of abnormal maternal echocardiographic findings in triplet pregnancies presenting with dyspnoea.


STUDY DESIGN
Between 2003 and 2013, patients' records of 96 triplet pregnancies at our department were analysed including maternal and fetal outcome, echocardiographic parameters and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. After exclusion of triplet pregnancies with fetal demise before 23 + 0 weeks, selective feticide or missing outcome data, the study population consisted of 60 triplet pregnancies. All women with dyspnoea underwent echocardiography and measurement of NT-proBNP.


RESULTS
Dyspnoea towards the end of pregnancy was observed in 13.3% (8/60) of all women with triplet pregnancies, and all of these women underwent echocardiography. The prevalence of abnormal echocardiographic findings in women with dyspnoea was 37.5% (3/8) with peripartum cardiomyopathy in one woman. Median serum NT-proBNP was significantly higher in women with abnormal echocardiographic findings compared with those without (1779 ng/ml, range 1045-6076 ng/ml vs 172 ng/ml, range 50-311 ng/ml; p < 0.001 by Mann-Whitney-U Test).


CONCLUSION
We conclude that triplet pregnancies presenting with dyspnoea show a high prevalence of abnormal echocardiographic findings. Since dyspnoea is a common sign in triplet pregnancies and is associated with a high rate of cardiac involvement, echocardiography and evaluation of maternal NT-proBNP could be considered to improve early diagnosis and perinatal management.
['Elhenicky|Marie|M|', 'Distelmaier|Klaus|K|', 'Mailath-Pokorny|Mariella|M|', 'Worda|Christof|C|', 'Langer|Martin|M|', 'Worda|Katharina|K|']
D000328:Adult D001317:Austria D015415:Biomarkers D015897:Comorbidity D004417:Dyspnea D004452:Echocardiography D005260:Female D006801:Humans D015994:Incidence D020097:Natriuretic Peptide, Brain D010446:Peptide Fragments D011247:Pregnancy D011249:Pregnancy Complications, Cardiovascular D059286:Pregnancy, Triplet D012307:Risk Factors D016216:Ultrasonography, Prenatal
Triplet pregnancy Pro-B-type natriuretic peptide Dyspnoea in pregnancy Maternal echocardiography Multiple pregnancy