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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Haemodynamic, invasive and echocardiographic monitoring in the hypertensive parturient

P Young1, R Johanson

  • 1North Staffordshire Maternity Unit, Newcastle Road, Stoke on Trent, Staffs, ST4 6QG, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 2, 2001
PubMed

Insights

This review found no randomized trials on the clinical usefulness of invasive (pulmonary artery catheters) or non-invasive (echocardiography) hemodynamic assessments in pre-eclampsia. Data on hemodynamic profiles exist, but clinical impact remains unclear.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Critical Care Medicine

Background:

  • Pre-eclampsia is a serious hypertensive disorder unique to pregnancy.
  • Hemodynamic assessment is crucial for managing severe pre-eclampsia.
  • The clinical utility of various hemodynamic monitoring techniques in pre-eclampsia remains debated.

Purpose of the Study:

  • To systematically review the literature on the clinical usefulness of invasive and non-invasive hemodynamic assessments in pre-eclampsia.
  • To evaluate the evidence supporting the use of pulmonary artery catheters and echocardiography in this patient population.

Main Methods:

  • A comprehensive systematic literature review was conducted.
  • MEDLINE database search using MESH headings and textwords.
  • Screening of over 1500 abstracts, followed by full-text review of 156 papers, with 55 yielding relevant data.

Main Results:

  • No randomized controlled trials were identified that demonstrate the clinical usefulness of pulmonary artery catheters or echocardiography in hypertensive pregnancy.
  • Extensive data exist on the hemodynamic profiles of women with pre-eclampsia.
  • A poor correlation was observed between right and left heart filling pressures, with unclear clinical impact.

Conclusions:

  • Current evidence does not support the routine clinical use of invasive or non-invasive hemodynamic monitoring for guiding management in pre-eclampsia.
  • Further research, particularly randomized controlled trials, is needed to establish the clinical value of these assessments.
Abstract

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