Hemodynamic Profile of Mild Pregnancy Induced Hypertension

An echocardiographic assessment of hemodynamics was performed in normotensive pregnant women, and in two categories of patients with mild pregnancy-induced hypertension (PIH): those with preeclampsia (PE, proteinuria 0.3g/24 hours) (n=23) and those with gestational hypertension (GH, proteinuria < 0.3g/24 hours) (n=22). The purpose of the study was to establish whether the two subsets of patients with PIH differ in respect to hemodynamics. Patients with PE had significantly lower stroke volume index and cardiac index than patients with GH, and normotensive pregnant women. Despite similar values of mean blood pressure, patients with PE had systemic vascular resistances higher than GH patients. In the PE group mean fetal weight was lower and the incidence of small for gestational age infants was higher than in the GH group.The differences in hemodynamic profile in patients with preeclampsia and in woman with gestational hypertension suggest that they represent two distinct pathophysiologic entities. PIH with proteinuria, despite “mild” elevation of blood pressure is predominantly associated with high systemic vascular resistance, which may explain poorer fetal outcome in this group of patients.