Gestational Hypervolemic Hypertension Is Clinically Different from “Classical” Preeclampsia

Objective: Homogenous pathogenesis of preeclampsia has been challenged. We examined the clinical characteristics of preeclamptic patients with discordant fetal growth which is one of the controversial issues in preeclampsia. Methods: Clinical index values including central hemodynamics of third-trimester preeclamptic patients with distinct fetal birth weights (group A: birth weight ≥ 50th percentile; n = 23 and group B: birth weight < 50th percentile; n = 14) were compared. Results: Pregnant women of group A were characteristically obese and edematous, but no fetal complications were observed. Patients of group B were younger, onset of preeclampsia was earlier, proteinuria was more severe, and fetal compromise was frequent. A marked difference between the two groups was noticed in central hemodynamics as the mean of CO (cardiac output) was 8.5 and 5.6 l/min in group A and B, respectively (p < 0.001). CO of less than 7.45 l/min was found to be associated with fetal birth weight below 50th percentile (OR = 15.6; 95% CI: 3.2 and 45.8, p = 0.001). Conclusions: Augmented CO in pregnancy may ensure efficient placental blood supply, but it may cause hypertension with subsequent moderate proteinuria. This condition, however, seems to be different from the “classical” preeclampsia.