Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

• DOI: 10.1055/a-2267-3994
• Publication Date: 2024-02-14T00:29:25Z
• Authors: Barbara Vasapollo; Sara Zullino; Gian Paolo Novelli; Daniele Farsetti; Serena Ottanelli; Sara Clemenza; Massimo Micaglio; Enrico Ferrazzi; Daniela Denis Di ...; Tullio Ghi; Elvira Di Pasquo; Rossana Orabona; Paola Corbella; Maria Grazia Frigo; Federico Prefumo; Tamara Stampalija; Stefano Raffaele ...; Herbert Valensise; Federico Mecacci
• Keywords: fetal growth restriction; 618; diabete; maternal hemodynamic; hypertensive disorders of pregnancy; 610; pregnancy; twin pregnancy; diabetes; fetal growth restriction; hypertensive disorders of pregnancy; maternal hemodynamics; pregnancy; preterm delivery; total peripheral vascular resistance; total peripheral vascular resistance; twin pregnancy; preterm delivery; total peripheral vascular resistance; Settore MEDS-21/A - Ginecologia e ostetricia; maternal hemodynamics

Objective The Italian Association of Preeclampsia (AIPE) and the Society Perinatal Medicine (SIMP) developed clinical questions on maternal hemodynamics state art. Study Design AIPE SIMP experts were divided in small groups invited to propose an overview existing literature specific topics related proposed, developing, wherever possible, and/or research recommendations based available evidence, expert opinion, importance. Draft with a rationale submitted 8th Consensus Expert Panel for consideration approval, at least 75% agreement required individual be included final version. Results More more evidence underlines relationship between fetal hemodynamics, as well cardiovascular profile fetal-maternal adverse outcomes such growth restriction hypertensive disorders pregnancy. Experts agreed proposing classification pregnancy hypertension, complications, states three different hemodynamic profiles depending total peripheral vascular resistance values: hypodynamic (>1,300 dynes·s·cm−5), normo-dynamic, hyperdynamic (<800 dynes·s·cm−5) circulation. This differentiation implies therapeutical strategies, drugs' characteristics, profile. Finally, characteristics women may useful rational approach appropriate follow-up, due increased risk later life. Conclusion Although might not conclusive, given lack large randomized trials, have great importance helping clinicians understanding pathophysiology chose treatment patients or complications. Key Points