Hemodynamic observations in severe pre-eclampsia with a flow-directed pulmonary artery catheter

Ten patients with severe pre-eclampsia were studied throughout labor and delivery and during the early puerperium with a flow-directed pulmonary artery catheter. Cardiac output was higher than previously described in normal patients. Pulmonary artery pressures were not significantly altered from the normal pregnant values. The usual increase in cardiac output occurring in the early puerperium was not observed in the patients with severe pre-eclampsia. Central venous pressure and pulmonary artery wedge pressure did not correlate in three of the nine patients studied. Left ventricular stroke work index was elevated in the patients with severe pre-eclampsia, suggesting a hyperdynamic state. The pulmonary artery catheter provided important new information in patients with severe pre-eclampsia and may be a useful clinical adjunct in patients with hemorrhage or oliguria and in patients needing a regional or general anesthetic.