Home Magazines Editors-in-Chief FAQs Contact Us

Hemodynamic phenotypes in preeclampsia, improving therapeutic strategies: a scoping review


Obstetrics & Gynecology International Journal
Saulo Molina-Giraldo,<sup>1,2,3,4</sup> Natalia Gutiérrez-Olaya,<sup>1,2 </sup>Diana Sterling-Castaño,<sup>1,2</sup> Felipe Murcia-Herrera,<sup>1,2</sup> Marcela Buitrago-Leal<sup>2,4,5</sup>

PDF Full Text

Abstract

Introduction: Preeclampsia (PE) is a multisystem hypertensive disorder classified among the great obstetrical syndromes, with an estimated prevalence of 2–8% worldwide. According to updated definitions (ISSHP/RBEHG), PE is characterized by new-onset hypertension after 20 weeks of gestation associated with proteinuria, maternal organ dysfunction, and/or placental involvement. Recent evidence describes two distinct hemodynamic phenotypes defined by maternal cardiovascular adaptation, each with specific clinical and paraclinical characteristics. Their identification may provide insight into underlying pathophysiology, allow more precise clinical management, and inform individualized selection of antihypertensive treatment. Objective: To identify and synthesize the available evidence on maternal hemodynamic profiles and phenotypic classifications in preeclampsia, and to examine their implications for diagnosis and therapeutic management.

Materials and Methods: We conducted a scoping review of literature published between January 1st 1980, and June 30th 2025, in PubMed/MEDLINE, Ebsco, Lilacs, and Embase. Articles and books in English and Spanish were considered using MeSH terms related to hemodynamic profiles, preeclampsia subtypes, maternal cardiovascular adaptation, and great obstetrical syndromes. Reviews and guidelines were also included to integrate evidence and clinical recommendations, with special attention to Latin American contributions.
The protocol for this scoping review was registered in the Open Science Framework (OSF) (DOI: 10.17605/OSF.IO/U5QDJ)
Results and conclusions: A total of 30 articles met inclusion criteria. The evidence supports that phenotypic classification of PE based on maternal hemodynamic adaptation offers a more accurate understanding of its heterogeneous pathophysiology. This approach may improve diagnostic stratification, support individualized antihypertensive selection, and help guide follow-up strategies, although prospective validation is still needed

Keywords

great obstetrical syndromes, preeclampsia classification, preeclampsia subtype, maternal cardiovascular adaptation, cardiac output, hemodynamics, gestational hypertension

Testimonials