Journal
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 35, Issue 25, Pages 4942-4945Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2021.1873269
Keywords
Preeclampsia; hypertension; maternal hemodynamics; cardiac output
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Cardiovascular changes during pregnancy are debated, with complications like hypertension leading to poor changes in cardiovascular health. Monitoring high TVR in chronic hypertension patients can help identify those at risk for developing severe conditions.
Cardiovascular changes that occur during pregnancy have been recently described and are matter of debate; during gestation we observe an increase in cardiac output and a reduction of peripheral total vascular resistance (TVR). In pregnancies complicated by hypertensive disorders, instead, these changes are lacking, with a persisting low cardiac output and high peripheral resistances. In this case report, we observed that in patients with chronic hypertension TVR are high, while the cardiac output is able to face the needs of pregnancy. The increase in TVR before the decision to deliver, due to bad blood pressure control despite therapy, may precede the alterations in blood tests (platelet decreasing and high liver enzymes). This data may be useful for monitoring patients with chronic hypertension and identifying those at higher risk of developing HELLP/severe preeclampsia.
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