Introduction: Hypertensive disease of pregnancy (HDP) is also known as maternal hypertensive disorder is a group of diseases such as preeclampsia gestational hypertension and chronic hypertension. A
study was undertaken to evaluate the cardiovascular  hemodynamic alterations in hypertensive disorders of pregnancy on echocardiography and assess its impact on maternal outcome.

Methods: A total of 100 pregnant patients presenting in our hospital with hypertension in 3rd trimester  were selected for the study matching the inclusion and the exclusion criteria. A detailed history of each case was recorded and a detailed examination wasperformed. Echocardiography was done to note structural changes noted in the heart along with
severity of disease.

Results: Out of Total 100 cases, 39 were gestational hypertension, 48 had pre eclampsia, 4 had eclampsia and 9 had chronic hypertension. Stroke volume was found to be significantly higher in eclampsia group.
Also the diastolic dysfunction (29%) was associated with severity of disease and 10 women had pulmonary hypertension in pre eclampsia and eclampsia group. There was significant change in LVID(S) and LVID
(D) showing changes of left eccentric ventricular hypertrophy in preeclampsia group and concentric left ventricular hypertrophy in chronic hypertensive group. An important finding in our study was the
structural parameters such as LVID D, LVID S, IVS and LWPW D were on higher side of normal or raised in HDP and the values were statistically significant in pre-eclampsia and eclampsia groups as compared with the normal reference values .

Conclusions: The study concluded that cardiac structure and function using echocardiography are altered in HDP. The severity of adverse changes seen in HDP is seen more in pre eclampsia and is proportional to the severity of the pre eclampsia. The cardiac functions which help in determination of impending dysfunction are the: LV end-diastolic
volume, LV end-systolic volume, ejection fraction, stroke volume, left atrial diameter and pulmonary hypertension. Out of these diastolic dysfunction and increased peripheral vascular resistance correlate
with disease severity.