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Review
. 2019 Mar;73(3):522-531.
doi: 10.1161/HYPERTENSIONAHA.118.11191.

Cardiovascular System in Preeclampsia and Beyond

Basky Thilaganathan  1   2 , Erkan Kalafat  3
Affiliations
Review

Cardiovascular System in Preeclampsia and Beyond

Basky Thilaganathan et al. Hypertension. 2019 Mar.

Abstract

Supplemental Digital Content is available in the text.

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Figures

Figure 1.
Figure 1.
Diagram illustrating the interaction between maternal cardiovascular function and placental function, maternal health, and fetal well-being. Placental oxidative stress or hypoxia is related to the relative balance of cardiovascular functional reserve and the cardiovascular volume/resistance load of pregnancy. The final common pathway that results in the signs and symptoms of preeclampsia involves the release of placental vasoactive substances. PIGF indicates placenta growth factor; and sFLT, soluble fms-like tyrosine kinase.
Figure 2.
Figure 2.
Diagrammatic representation of the consequences of a relative imbalance of cardiovascular functional reserve and cardiovascular volume/resistance load of pregnancy. Cardiovascular adaptation in normal pregnancy (green dotted line) results in subclinical cardiac dysfunction in a small but significant proportion of women at term. Poor cardiovascular adaptation to pregnancy (red dotted line) is more likely to occur with advanced maternal age, obesity, and other risk factors. Depending on the cardiovascular load of pregnancy (normal load: green solid line, excessive load: red solid line), different preeclampsia (PE) phenotypes will manifest, such as early or late PE.
Figure 3.
Figure 3.
Hazard ratios for chronic hypertension by severity of preeclampsia and time since pregnancy according the national register cohort study by Behrens et al. Hazard ratios compare rates of chronic hypertension among women with hypertensive disorders of pregnancy and delivery <34 gestational wk (orange), delivery at 34–36 wk (green), and delivery ≥37 gestational wk (black).
Figure 4.
Figure 4.
Infographic outlining involvement of the maternal cardiovascular system in the pathogenesis and recovery from preeclampsia (PE). BP indicates blood pressure.
See this image and copyright information in PMC

References

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