ISUOG Consensus Statement on maternal hemodynamic assessment in hypertensive disorders of pregnancy and fetal growth restriction

T Stampalija^{1

2}, C Lees^{3

4}, T Ghi⁵, J Cornette⁶, W Gyselaers^{7

8}, E Ferrazzi^{9

10}, T Mousa¹¹, M Spaanderman^{12

13}, B Thilaganathan^{14

15}, H Valensise^{16

17}; Collaborators

Collaborators, Affiliations

Collaborators

Collaborators:
J J Duvekot, C Ghossein-Doha, C McEniery, F Mecacci, G P Novelli, B Vasapollo, I Wilkinson

Affiliations

¹ Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
² Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.
³ Centre for Fetal Care, Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
⁴ Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
⁵ Catholic University of Sacred Heart Rome, Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁶ Department of Obstetrics and Gynecology, Division Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁷ Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.
⁸ Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
⁹ Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
¹⁰ Department of Community and Health Sciences, University of Milan, Milan, Italy.
¹¹ Maternal and Fetal Medicine Unit, University of Leicester, Leicester, UK.
¹² Department of Obstetrics and Gynecology, Maastricht University Medical Center, The Netherlands.
¹³ Department of Gynaecology and Obstetrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
¹⁴ Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.
¹⁵ Molecular and Clinical Sciences Research Institute, St. George's University of London, London, UK.
¹⁶ Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy.
¹⁷ Department of Obstetrics and Gynecology, Policlinico Casilino, Rome, Italy.

PMID: 40997762
PMCID: PMC12579779
DOI: 10.1002/uog.70040

ISUOG Consensus Statement on maternal hemodynamic assessment in hypertensive disorders of pregnancy and fetal growth restriction

T Stampalija et al. Ultrasound Obstet Gynecol. 2025 Nov.

. 2025 Nov;66(5):681-696.

doi: 10.1002/uog.70040. Epub 2025 Sep 25.

Authors

T Stampalija^{1

2}, C Lees^{3

4}, T Ghi⁵, J Cornette⁶, W Gyselaers^{7

8}, E Ferrazzi^{9

10}, T Mousa¹¹, M Spaanderman^{12

13}, B Thilaganathan^{14

15}, H Valensise^{16

17}; Collaborators

Collaborators

Collaborators:
J J Duvekot, C Ghossein-Doha, C McEniery, F Mecacci, G P Novelli, B Vasapollo, I Wilkinson

Affiliations

¹ Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
² Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.
³ Centre for Fetal Care, Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
⁴ Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
⁵ Catholic University of Sacred Heart Rome, Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁶ Department of Obstetrics and Gynecology, Division Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁷ Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.
⁸ Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.
⁹ Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
¹⁰ Department of Community and Health Sciences, University of Milan, Milan, Italy.
¹¹ Maternal and Fetal Medicine Unit, University of Leicester, Leicester, UK.
¹² Department of Obstetrics and Gynecology, Maastricht University Medical Center, The Netherlands.
¹³ Department of Gynaecology and Obstetrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
¹⁴ Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK.
¹⁵ Molecular and Clinical Sciences Research Institute, St. George's University of London, London, UK.
¹⁶ Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy.
¹⁷ Department of Obstetrics and Gynecology, Policlinico Casilino, Rome, Italy.

PMID: 40997762
PMCID: PMC12579779
DOI: 10.1002/uog.70040

No abstract available

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Figures

**Figure 1**
Major maternal hemodynamic changes in healthy pregnancy. CO, cardiac output; GFR, glomerular filtration rate; HR, heart rate; IVRT, isovolumetric relaxation time; LA, left atrial; LV, left ventricular; MAP, mean arterial pressure; RAAS, renin–angiotensin– aldosterone system; RBC, red blood cells; SV, stroke volume; SVR, systemic vascular resistance.

**Figure 2**
Early maternal hemodynamic changes in healthy pregnancy. hCG, human chorionic gonadotropin; NO, nitric oxide, Pg, progesterone; RAAS, renin–angiotensin–aldosterone system.

**Figure 3**
Diagram representing two phenotypes of hypertensive disorders of pregnancy (HDP): (a) resistance‐dominant HDP and (b) volume‐dominant HDP. FGR, fetal growth restriction; AGA, appropriate‐for‐gestational age.

See this image and copyright information in PMC

References

1. Capeless EL, Clapp JF. Cardiovascular changes in early phase of pregnancy. Am J Obstet Gynecol. 1989;161:1449‐1453. - PubMed
1. Clapp JF, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol. 1997;80:1469‐1473. - PubMed
1. Cornette J, Roos‐Hesselink JW. Normal cardiovascular adaptation to pregnancy. Evidence‐Based Cardiology Consult. Springer; 2014:423‐432.
1. de Haas S, Ghossein‐Doha C, van Kuijk SMJ, van Drongelen J, Spaanderman MEA. Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta‐analysis. Ultrasound Obstet Gynecol. 2017;49:177‐187. - PubMed
1. Duvekot JJ, Cheriex EC, Pieters FA, Menheere PP, Peeters LH. Early pregnancy changes in hemodynamics and volume homeostasis are consecutive adjustments triggered by a primary fall in systemic vascular tone. Am J Obstet Gynecol. 1993;169:1382‐1392. - PubMed

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ISUOG Consensus Statement on maternal hemodynamic assessment in hypertensive disorders of pregnancy and fetal growth restriction

Collaborators

Affiliations

ISUOG Consensus Statement on maternal hemodynamic assessment in hypertensive disorders of pregnancy and fetal growth restriction

Authors

Collaborators

Affiliations

Figures

References

LinkOut - more resources

Full Text Sources