Hemodynamic phenotypes in preeclampsia, improving therapeutic strategies: a Scoping review

Preeclampsia (PE) is a multisystem hypertensive disorder classified among the great obstetrical syndromes, with an estimated prevalence of 2–8% worldwide. According to updated definitions (ISSHP/RBEHG), PE is characterized by new-onset hypertension after 20 weeks of gestation associated with proteinuria, maternal organ dysfunction, and/or placental involvement. Recent evidence describes two distinct hemodynamic phenotypes defined by maternal cardiovascular adaptation, each with specific clinical and paraclinical characteristics. Their identification may provide insight into underlying pathophysiology, allow more precise clinical management, and inform individualized selection of antihypertensive treatment. Objective: To identify and synthesize the available evidence on maternal hemodynamic profiles and phenotypic classifications in preeclampsia, and to examine their implications for diagnosis and therapeutic management.