Hemodynamic adjustments during pregnancy: opportunities for tailored treatment to prevent preeclampsia

Preeclampsia is a pregnancy complication characterized by hypertension along with proteinuria or other signs of maternal organ dysfunction. It is a leading cause of maternal and neonatal mortality and morbidity in the Western world. Remotely, preeclampsia associates with early development of cardiovascular and metabolic diseases in affected women and their offspring. Blood pressure is measured during every pregnancy check-up. However, elevation of blood pressure is a late symptom in the development of preeclampsia. Abnormal cardiovascular function often precedes blood pressure elevation. This thesis emphasizes the importance of measuring cardiovascular function in order to identify women with an increased risk of preeclampsia. On the one hand, women with increased risk can be advised general preventive measures including daily low-dose aspirin. On the other hand, it is possible to modulate cardiovascular function with personalized blood pressure medication. The risk of recurrent preeclampsia is halved by this strategy. New and efficient measurement methods facilitate cardiovascular function measurements during outpatient check-ups.