Normal Echocardiographic Findings in Healthy Pregnant Women: A Narrative Review of the Literature.

Abstract

During pregnancy, significant physiological changes occur that result in cardiac remodeling and altered functional performance, though these are generally reversible postpartum. Pregnancy increases the cardiovascular system's demand, requiring substantial adaptations such as elevated cardiac output (CO), plasma volume, stroke volume (SV), and heart rate (HR), alongside a reduction in systemic vascular resistance (SVR) and mean arterial pressure. These adaptations, essential to meet the hemodynamic needs of both the mother and fetus, often differ from standard echocardiographic measurements used to evaluate cardiac function, making interpretation challenging. Accurate identification of normal echocardiographic parameters during pregnancy is crucial to establishing a baseline for detecting pathological changes. Deviations from these baselines, when recognized early, can assist in risk stratification and inform clinical management of conditions such as heart failure, arrhythmias, or valvular disease. However, many existing studies rely on cross-sectional designs, limiting their ability to provide comprehensive longitudinal insights. For pregnant women, the lack of standardized echocardiographic reference values represents a critical gap. The physiological changes unique to this population, including increased CO and ventricular dimensions, complicate the interpretation of echocardiographic studies using non-pregnant norms. This shortfall can hinder the identification of subclinical cardiovascular alterations, delaying timely intervention. The development of pregnancy-specific echocardiographic reference values is essential for advancing preventive and personalized care. Such tailored references would improve diagnostic accuracy, facilitating early detection and management of pregnancy-related cardiac changes and their potential pathological implications.