Haemodynamic, invasive and echocardiographic monitoring in the hypertensive parturient

P Young, R Johanson
Best Practice & Research. Clinical Obstetrics & Gynaecology 2001, 15 (4): 605-22

AIM: To determine the clinical usefulness of invasive and non-invasive haemodynamic assessment in pre-eclampsia.

METHOD: A systematic review of the literature was undertaken, using a MEDLINE electronic search using a combination of MESH headings and textwords. Over 1500 abstracts were perused; we obtained 156 full papers that were related to the subject matter. Of the full papers, 55 yielded relevant information. Hand-searching the reference lists of the retrieved papers completed the search.

RESULTS: There are no data from randomized controlled clinical trials illustrating the clinical usefulness of pulmonary artery catheters or echocardiographic techniques in hypertensive pregnancy. There are a wealth of data illustrating the haemodynamic profiles of both untreated and treated pre-eclamptic women. Data are also available comparing right heart and left heart filling pressures, demonstrating a relatively poor correlation between the two values. The clinical impact of either measurement is unclear. Data are available illustrating the correlation between echocardiographic techniques and pulmonary artery catheterization.

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