Aim: To evaluate whether there is a significant relationship between hemodynamic models and pre-eclampsia outcomes.
Method: A controlled experimental study was performed. We analyzed 2910 hemodynamic series systematically sampled from 970 pregnant women three times every 2 weeks from the definite diagnosis of pre-eclampsia until delivery. Women were divided into three groups based on total peripheral resistance (TPR): a low-TPR group, a normal-TPR group and a high-TPR group. Every group was divided into three subgroups based on cardiac index (CI): a low-CI subgroup, a normal-CI group and high-CI group. Common lab tests, electrocardiographic examination, fundus examination, cardiac function, liver function and kidney function were measured after every hemodynamic monitoring. Primary outcomes included various maternal and neonatal morbidity and neonatal and infant mortality.
Results: In our study we found seven hemodynamic models in pre-eclampsia during the third trimester of pregnancy. No significant differences in maternal age, weight, and height were observed between the three groups. The low-TPR and normal-TPR groups showed better disease results than the high-TPR group in respect of HELLP (P < 0.01), lung edema (P < 0.01), acute renal failure (P < 0.01), heart failure (P < 0.01), neonatal intensive care unit admission (P < 0.01), infant weight (P < 0.01), neonatal mortality (P < 0.01) and infant mortality (P < 0.01). The low-TPR group had better results than the normal-TPR group in respect of eclampsia (P < 0.01), liver hemorrhage (P < 0.01), birthweight (P < 0.01) and gestational week at birth (P < 0.05).
Conclusion: Among all the subgroups, the highest maternal and neonatal morbidity was in the high-TPR-high-CI subgroup. There is clear relationship between hemodynamic and disease outcomes during the third trimester.