Haemodynamic, invasive and echocardiographic monitoring in the hypertensive parturient

Aim. To determine the clinical usefulness of invasive and non-invasive haem odynamic assessment in pre-eclampsia. Method. A systematic review of the literature was undertaken, using a MEDLI NE electronic search using a combination of MESH headings and textwords. Ov er 1500 abstracts were perused; we obtained 156 full papers that were relat ed to the subject matter. Of the full papers, 55 yielded relevant informati on. Hand-searching the reference lists of the retrieved papers completed th e search. Results. There are no data from randomized controlled clinical trials illus trating the clinical usefulness of pulmonary artery catheters or echocardio graphic techniques in hypertensive pregnancy. There are a wealth of data il lustrating the haemodynamic profiles of both untreated and treated pre-ecla mptic women. Data are also available comparing right heart and left heart f illing pressures, demonstrating a relatively poor correlation between the t wo values. The clinical impact of either measurement is unclear. Data are available illustrating the correlation between echocardiographic t echniques and pulmonary artery catheterization.