{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:53Z","timestamp":1790575073318,"version":"4.1.0"},"reference-count":130,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Plain Language Summary<\/jats:title>\n                  <jats:p>Pre\u2010eclampsia is a pregnancy complication that involves the development of high blood pressure in a pregnant woman and other features such as protein in the woman's urine, kidney or liver problems, or poorer growth for the baby. It can also have long\u2010term health impacts for the mother after pregnancy. Pre\u2010eclampsia typically occurs after 20\u2009completed weeks of pregnancy (either mid\u2010pregnancy known as \u2018early onset pre\u2010eclampsia\u2019 or, more commonly, later in pregnancy, at or after 34 weeks, known as \u2018late onset\u2019 pre\u2010eclampsia).<\/jats:p>\n                  <jats:p>Different blood pressure medications can be used to treat this condition, but not all women respond in the same way to the same medication. This is probably due to variables in the function of the maternal heart and blood vessels.<\/jats:p>\n                  <jats:p>Over the past 20\u2009years, technological developments have meant it is now possible to measure important individual aspects of maternal cardiovascular function, using simple non\u2010invasive tests. These tests can establish whether the mother's heart and circulatory system have any unusual features that may place her at higher risk of complications. They can also be used to monitor whether the mother's health and circulatory system is adapting in the right way to the pregnancy. For example, it is now possible to measure cardiac output (volume of blood pumped out by the heart) and vascular resistance (the physical resistance to the flow of blood), as well as the mother's blood pressure. It is also possible to monitor if and how changes in the above follow the patterns of change that are usually seen during pregnancy. Testing, and repeat testing as necessary, can identify individual measurements, or patterns of measurements, of concern and can identify whether the mother's heart and blood flow are adapting to the pregnancy in the typical and expected way. Studies in these areas have shown two distinct patterns of abnormal measurements of blood circulation and heart health in the pregnant woman that can occur with pre\u2010eclampsia. Some changes and abnormalities can be detected before the symptoms of pre\u2010eclampsia become obvious. Some features associated with pre\u2010eclampsia can also be detected early in pregnancy or even before pregnancy. For example, we understand that some pregnant women who have a lower volume of blood being pumped out of their hearts per minute (low cardiac output), are more at risk of being affected by pre\u2010eclampsia earlier in pregnancy, and more likely to have a baby with a low birth weight. Women that develop pre\u2010eclampsia later in pregnancy typically have more circulating blood and babies of normal or larger size.<\/jats:p>\n                  <jats:p>The distinct measurable features of maternal heart health and blood flow can be used to identify those women at risk of developing pre\u2010eclampsia at an early stage. Recognising the features of maternal heart health and the patterns of blood flow associated with pre\u2010eclampsia provides an opportunity to individualise treatment plans for pregnant women, such as a personalised plan of monitoring and review, and using the most appropriate drugs that are tailored to address specific difficulties and likely to be most effective in restoring balance to the circulatory system of that individual. Early recognition, before the onset of symptoms, also allows timely reviews, and appropriate treatment to be started sooner. This, in turn, can lower the incidence of serious manifestations of pre\u2010eclampsia for the mother, such as the development of seizures or a stroke.<\/jats:p>\n                  <jats:p>There is clear evidence that the management of pre\u2010eclampsia can be improved by more detailed cardiovascular evaluation and tailored monitoring. The drugs that lower blood pressure work in different ways and the opportunity exists to target therapy to the underlying problem, however at the time of writing, many of the non\u2010invasive tests and assessments able to identify women at risk of pre\u2010eclampsia are typically only being used in a research setting. Routine clinical use of the available tests, and the establishment of clear care pathways and defined parameters for risk assessment based on those maternal heart and circulation test results, would allow targeted treatment and assist in preventing avoidable harm.<\/jats:p>","DOI":"10.1111\/1471-0528.70275","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:00:36Z","timestamp":1785798036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010Eclampsia and Maternal Cardiovascular Function: Insights Into Pathophysiology and Care (Scientific Impact Paper No. 79)"],"prefix":"10.1111","volume":"133","author":[{"given":"F. 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