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Phenotype-Directed Management of Hypertension in Pregnancy
Kelsey McLaughlin1, John W Snelgrove1, Laura E Sienas2
1Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine Sinai Health SystemUniversity of Toronto Toronto Canada.
Journal of the American Heart Association
|March 14, 2022
Summary
Tailoring clinical care for hypertensive disorders of pregnancy using phenotype-based strategies can reduce adverse outcomes. Novel approaches like placental growth factor testing and hemodynamic monitoring show promise for high-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Cardiology in Pregnancy
Background:
- Hypertensive disorders of pregnancy are serious obstetric complications.
- Current management often lacks tailoring to specific disease pathogenesis.
- This can lead to adverse maternal and perinatal outcomes.
Purpose of the Study:
- To review phenotype-based clinical strategies for managing high-risk pregnancies with hypertensive disorders.
- To highlight novel approaches not yet in common clinical practice.
Main Methods:
- Narrative review of current literature and clinical practices.
- Discussion of real-time placental growth factor testing.
- Explanation of noninvasive hemodynamic monitoring for antihypertensive therapy guidance.
Main Results:
- Phenotype-based strategies are not widely integrated into routine obstetric care.
- Real-time placental growth factor testing is utilized at Mount Sinai Hospital.
- Noninvasive hemodynamic monitoring guides antihypertensive therapy at UW Medical Center.
Conclusions:
- Integrating phenotype-based strategies can improve outcomes in high-risk pregnancies.
- Widespread adoption of novel testing and monitoring is recommended.
- Further research and implementation are needed to reduce adverse maternal-fetal outcomes.
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