LAUSR

Background Placental disorders such as hypertensive disorders of pregnancy (HDP) and are associated with de novo changes in uterine artery pulsatility index (PI) and cardiovascular indices. The aim of this study is to explore the relationship between central and uterine haemodynamics in pregnancies complicated by HDP compared to controls. Methods A prospective study involving ongoing third trimester pregnancies complicated by HDP, as well as healthy controls. Maternal central haemodynamics were measured using an USCOM-1A® device and uterine artery Doppler assessments were carried out by a standardised technique. Indices that varied physiologically with gestation or maternal characteristics were corrected for by calculating multiples of the median (MoM). Results The study included 211 HDP and 446 control pregnancies. Compared to controls, HDP pregnancies had significantly (all p  Conclusion HDP pregnancies are associated with altered central maternal haemodynamics – namely reduced cardiac output and increased systemic vascular resistance. Maternal haemodynamics is further deranged with more severe phenotypes of HDP. Changes in third trimester uterine artery PI are likely to be a consequence rather than the cause of modified central haemodynamics in HDP.