The primary goal of this observational study is to learn about postpartum pulmonary artery
pressure in women who suffered from Preeclampsia and Antiphospholipid Syndrome.
The main question it aims to answer is whether the conjunction of preeclampsia with obstetric
antiphospholipid syndrome significantly foster the development of long-lasting pulmonary
Only participants who suffered from preeclampsia during pregnancy will be followed for a
period up to 3 years postpartum. Researchers will compare women with or without obstetric
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The disease, disorder, syndrome, illness, or injury that is being studied.
Preeclampsia (PE), a multisystem disease affecting 2-8% of all pregnancies is a major cause
of mother and child mortality and morbidity worldwide. On the long term, women who suffered
from PE during pregnancy are prone to develop various cardiovascular diseases including
arterial hypertension, heart failure, aortic stenosis, mitral regurgitation and atrial
In an effort to prevent or early detect any potential cardiovascular complications in this
population, the investigators implemented in Inselspital, 6 years ago, a join consultation
between cardiologist and obstetrician. Since 2016, a roughly 100 women/year have been
followed at this consultation. As part of this follow-up, in addition to a clinical
examination, echocardiography, blood sampling and 24h ambulatory blood pressure monitoring
were performed. To the best of the investigators knowledge, this represent the first cohort
of this kind in Switzerland. Therefore, it offers a unique opportunity to study the effect of
PE on the long term cardiovascular phenotype.
Although the majority of PE are of unknown origin a fraction is due to an autoimmune disease,
the Antiphospholipid Syndrome (APS). APS is known to triple the risk of developing PE and is
found in up to 20% in women with the most severe forms of PE. There are two distinguished
entities of APS, one associated with vascular complications (vascular APS) and one associated
with adverse pregnancy outcomes (obstetric APS (oAPS)). In the former form, the prevalence of
pulmonary hypertension has been reported to be between 2% and 17% (incidence in the general
population ~ 1/100'000) but remain unknown in oAPS. This is of prime importance as pulmonary
arterial hypertension is a rare disease with elevated mortality and limited treatment
availability. Furthermore, for unknown raison, women have up to seven times the risk of men
to develop PH. Here, the investigators hypothesize that oAPS could be an unrecognized risk
factor for the development of PH in women.
In patients who suffered from PE, epidemiological studies shown that the risk for developing
arterial hypertension, stroke or heart failure is 2-4 fold higher. But structured follow-up
to better target this population is missing. Our established interdisciplinary consultation
offer a unique possibility to better understand the link between PE and cardiovascular
outcomes later in life. Therefore, the investigators further aimed in this study, first to
assess the prevalence of the above mentioned cardiovascular outcomes, and second, to
establish prediction models, for example for the development of arterial hypertension in
patient that suffered from PE.
The primary objective of this study is to compare the postpartum pulmonary arterial pressure
measured non-invasively by echocardiography in women after PE with or without oAPS by
collecting routine data for the analysis.The secondary objective is to compare the right and
left cardiac function using echocardiography images and the systemic blood pressure between
both groups by collecting routine data for the analysis. Further, the investigators aimed to
assess the prevalence of arterial hypertension in this population, 3 years postpartum and
establish a prediction model of the development of arterial hypertension by collecting
routine data for the analysis.
The investigators are planning a single center retrospective and prospective study where
routine data is collected to evaluate the objectives described above. In particular,
demographic, biophysical as well as echocardiographic parameters of all the patients whose
pregnancies were complicated by preeclampsia, and were or will be referred after delivery to
our outpatient clinic will be collected and analyzed. All consenting patients (see chapter 9)
followed between 2016 and 2025 will be enrolled. All data will be collected during a period
ranging from 2016 to 2028 encompassing the first patient enrolment in 2016 and the end of the
3 years routine follow-up of the last patient enrolled in 2025.
: Preeclampsia and obstetric Antiphospholipid Syndrome
Women in this group wil be followed during 3 years. Echocardiography images, 24-hour ambulatory blood pressure monitoring will be collected.
: Preeclampsia without obstetric Antiphospholipid Syndrome
Diagnostic Test: - Echocardiography images
Transthoracic echocardiographic (Vivid E95) performed in all included patients between three months and three years after delivery.
Left ventricular ejection fraction,
Left ventricular mass index,
Septal and lateral mitral annular E-wave velocity assessed by tissue Doppler,
Tricuspid annular plane systolic excursion,
Left atrial volume index,
Right ventricle to right atrium (RV/RA) gradient
Diagnostic Test: - 24-hour ambulatory blood pressure monitoring
Twenty-four-hour ABPM performed between three months and three years after delivery using validated recorders (Spacelabs model 90217, USA)
If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.
Bern, , 3010
Emrush Rexhaj, MD