Dissertation to explore echocardiography’s efficacy

Methods
Research Design

We conducted an evaluation dissertation to explore echocardiography’s efficacy in assessing cardiac function among high-risk pregnancies. This approach allows us to check the extent to which the intervention, in this case, echocardiography, is working in diagnosing and managing cardiac conditions among pregnant women.
The study was conducted using a secondary research strategy where data for the investigation was collected from studies presenting the role of echocardiography in the diagnosis and management of cardiovascular disorders among high-risk pregnant women. The selection of a secondary design was fuelled by many factors, including the limited access to a broad scope of participants and the secondary presenting time and cost constraints. Additionally, the design was the best option for the topic since it allowed for spatial freedom on the researchers’ part in obtaining information from a more comprehensive population range. It also allowed using different variables (normative cardiovascular changes among high-risk pregnancies) to analyze primary data, which the researchers included only appropriate. While strengthened by the above advantages, we will also control the primary data quality.
During the search for secondary data sets to use during the investigation, we noted a deficit in studies directly analyzing the efficacy of echocardiography in diagnosing cardiovascular conditions among pregnant women, especially those with high-risk pregnancies. Many studies involving echocardiography primarily examined the diagnosis of cardiovascular disorders in terms of their occurrence among women. The studies also covered one or more of the outcomes of interest. However, none covered many of the outcomes.As noted previously, echocardiography detects the blood-pumping characteristic of the cardiac chambers. It is also used to estimate the valves’ integrity by measuring the current production to analyze the heart’s rhythm. Since pregnant women, primarily those with pre-existing or undiagnosed underlying cardiovascular conditions, are at constant risk of developing or worsening cardiovascular complications, much interest has developed in risk mitigation. We, therefore, wanted to only focus on studies that provide findings on the efficacy of Echo evaluation of the heart during pregnancy. We selected several studies that covered our outcomes of interest. Secondary data will be obtained from select studies using longitudinal, observational, and retrospective study designs.
Participants
Studies drew primary data from mixed methods, including quantitative (surveys and questionnaires) and qualitative (interviews, focus groups, observations, and case studies) approaches.Participants for the study included women of childbearing age (> 18 years) with their data, including patient demographics and medical histories provided. We also required that the included studies provide a statement claiming the collection of informed and written consent from the included participants. Other data collected from the selected studies include a family medical history of cardiac conditions; baseline blood pressure (systolic, diastolic, and mean arterial pressure); previous or pre-existing cardiovascular disease; andanthropometrics (basal metabolic rates, body circumference, weight, height).
Study Location
Owing to the collection of data from secondary sources, primarily published data sources, we did not place any restrictions on the location of our study.
Procedure
We collected secondary data from published journals, including MEDLINE, EMBASE, CochraneLibrary, andGoogle Scholar. We searched these databases using keywords, including: “echocardiography,” “high-risk pregnancies,” “pregnancy,” “pre-eclampsia,” “cardiovascular events,” “cardiovascular complications,” “diagnosis,” “management,” and “hypertensive disorders.” Within the databases, we also identified only studies conducted as primary studies, excluding reviews, case reports, supplant studies, and commentaries. In addition, we only included studies that provided cardiovascular outcome data among pregnant women after diagnosis using echocardiography. Those that analyzed echocardiography compared to other diagnostic methods, including traditional 2D imaging, were also included. We also noted during this study screening process that many studies analyzing the role of echocardiography in the diagnosis and management of pre-eclampsia among high-risk pregnant women focused on women with pre-eclampsia. In line with this approach by most studies analyzing our subject of interest, we also included these studies as primary data sources. In line with our topic, we were interested in the following measures:
Chamber size –This occurs because ofcardiac hypertrophy after the enlargement of the heart ventricles from sustained pressure overload. The process is physiologically adaptive to accommodate the pregnancy and leads to increased chamber size and an expected rise of cardiac chamber parameters, especially the left ventricular mass index. Relative wall thickness is also a relevant outcome that can be diagnosed with echocardiograms.
Blood Pressure Changes- The changes in the blood volume are expected to cause a subsequent increase in blood pressure. The studies presented blood pressure changes, including diastolic, systolic, and mean arterial pressure values. The left ventricular function of the heart is also presented as an E/A ratio which represents the blood flow from early(E) to late(A) diastole.
Analyzed Measures
Echocardiography can detect physiological changes among pregnant women by examining mitral, tricuspid, and aortic valvular regurgitation, dilation, and chamber enlargement.