Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Pre-Eclampsia and Italian Society of Perinatal Medicine (Feb, 10.1055/a-2267-3994, 2024)

被引：1

作者：

Vasapollo, Barbara ^{[1
,2
]}

Zullino, Sara ^{[3
]}

Novelli, Gian Paolo ^{[4
,17
]}

Farsetti, Daniele ^{[1
,2
]}

Ottanelli, Serena ^{[3
]}

Clemenza, Sara ^{[3
]}

Micaglio, Massimo ^{[5
]}

Ferrazzi, Enrico ^{[6
,7
]}

Di Martino, Daniela Denis ^{[6
]}

Ghi, Tullio ^{[8
]}

Di Pasquo, Elvira ^{[8
]}

Orabona, Rossana ^{[9
]}

Corbella, Paola ^{[10
]}

Frigo, Maria Grazia ^{[11
]}

Prefumo, Federico ^{[12
]}

Stampalija, Tamara ^{[13
,14
]}

Giannubilo, Stefano Raffaele ^{[15
,16
]}

Valensise, Herbert ^{[1
,2
]}

Mecacci, Federico ^{[3
]}

机构：

[1] Tor Vergata Univ, Dept Surg Sci, Rome, Italy

[2] Policlin Casilino, Div Obstet & Gynecol, Rome, Italy

[3] Univ Hosp Careggi, Dept Obstet & Gynecol Biomed Expt & Clin Sci, Florence, Italy

[4] Policlin Tor Vergata, Dept Integrated Care Serv, Prehosp Unit, Rome, Italy

[5] Azienda Osped Univ Careggi, Dept Anesthesia & Intens Care, Unit Obstet & Gynecol Anesthesia, Florence, Italy

[6] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Dept Obstet & Gynecol, Dept Woman Child & Newborn,Unit Obstet, Milan, Italy

[7] Univ Milan, Dept Clin & Community Sci, Milan, Italy

[8] Univ Parma, Dept Med & Surg, Obstet & Gynecol Unit, Parma, Italy

[9] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[10] ASST Grande Osped Metropolitano Niguarda, Maternal Infant Dept SC, Obstet & Gynecol, Milan, Italy

[11] San Giovanni Calibita Fatebenefratelli Hosp, Dept Anesthesia & Resuscitat Obstet, Rome, Italy

[12] IRCCS Ist Giannina Gaslini, Obstet & Gynecol Unit, Genoa, Italy

[13] IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Unit Fetal Med & Prenatal Diag, Trieste, Italy

[14] Univ Trieste, Dept Med Surg & Hlth Sci, Trieste, Italy

[15] Marche Polytech Univ, Dept Obstet & Gynecol, Ancona, Italy

[16] Polytech Univ Marche, Salesi Hosp, Dept Clin Sci, Ancona, Italy

[17] Policlin Tor Vergata, Viale Oxford 81, I-00133 Rome, Italy

来源：

AMERICAN JOURNAL OF PERINATOLOGY | 2024年 / 41卷 / 14期

关键词：

Diabetes; Fetal Growth Restriction; Hypertensive Disorders of Pregnancy; Maternal hemodynamics; Pregnancy; Preterm Delivery; Total Peripheral Vascular Resistance; Twin Pregnancy;

D O I：

10.1055/s-0044-1786746

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

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

引用

页码：e1 / e1

页数：1