Different Hemodynamic Types of Preeclampsia Observed Under Ultrasonic Cardiac Output Monitor (USCOM): A Report of Two Cases

Abstract

Preeclampsia is a serious and uncommon complication of pregnancy, which affects 5% to 7% of pregnancies and is associated with maternal and fetal adverse outcomes. Moreover, preeclampsia is a polymorphic disease with different hemodynamic types, thus requiring different therapeutic strategies. As a hemodynamic tool, the ultrasonic cardiac output monitor (USCOM) is useful in the detection of preeclampsia as early as the 5th to 16th week of gestation, with abnormal hemodynamic indicating preeclampsia. Although blood pressure (BP) rises in preeclamptic patients, it is not a sensitive indicator for the diagnosis of preeclampsia. However, hemodynamic may change in the 5th to 11th week of gestation. In this paper, the hemodynamic types of two cases were reported using USCOM. The SV, CO, and SVRI values were significantly different in both the cases, indicating the patients had different types of preeclampsia. The hemodynamic parameters were more useful than blood pressure for managing the two cases. Moreover, the mother and fetal were safe after treatment. If preeclampsia had been assessed only from the perspective of BP, the two cases would have been diagnosed as having mild hypertension, and we would not be able to determine the severity. USCOM allowed the identification of preeclampsia-associated hemodynamics and defined individualized therapeutic targets, which cannot be identified by BP alone.