Echocardiographic estimation of hemodynamics in hypertensive pregnancy

M-mode echocardiography and indirect blood pressure measurements were used to examine hemodynamics in three groups of pregnant patients: 19 who were preeclamptic, nine who had essential hypertension, and 19 who were normotensive. The preeclamptic patients had significantly lower heart rate (68.4 versus 74.7 beats/min, p less than 0.05), stroke volume (89 versus 101 ml; p less than 0.02), and cardiac index (5.9 versus 7.5 L/min/sq m; p less than 0.001) than those of control patients matched for age, parity, and gestational age. The mean values for heart rate, stroke volume, and cardiac index in patients with essential hypertension were not significantly different from those in the control group; however, the former had widely varying individual hemodynamic patterns. The significant inverse correlation was found between cardiac index and mean blood pressure (r = -0.602) in preeclamptic patients. There was a positive correlation between maternal cardiac index and infant birth weight (r = 0.813) and also inverse relationship between systemic vascular resistance and infant birth weight (r = -0.890) in this group. Possible explanations for these findings are discussed.