Methods and considerations concerning cardiac output measurement in pregnant women: recommendations of the International Working Group on Maternal Hemodynamics

Ultrasound Obstet Gynecol. 2019 Jul;54(1):35-50. doi: 10.1002/uog.20231.


Cardiac output (CO), along with blood pressure and vascular resistance, is one of the most important parameters of maternal hemodynamic function. Substantial changes in CO occur in normal pregnancy and in most obstetric complications. With the development of several non-invasive techniques for the measurement of CO, there is a growing interest in the determination of this parameter in pregnancy. These techniques were initially developed for use in critical-care settings and were subsequently adopted in obstetrics, often without appropriate validation for use in pregnancy. In this article, methods and devices for the measurement of CO are described and compared, and recommendations are formulated for their use in pregnancy, with the aim of standardizing the assessment of CO and peripheral vascular resistance in clinical practice and research studies on maternal hemodynamics. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Keywords: cardiac MRI; cardiac output; impedance cardiography; inert-gas rebreathing technique; pregnancy; pulmonary artery catheter; pulse-contour analysis; transthoracic echocardiography.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Cardiac Output / physiology*
  • Catheterization, Swan-Ganz / methods
  • Echocardiography / methods*
  • Female
  • Heart / diagnostic imaging
  • Heart / physiology
  • Hemodynamics / physiology*
  • Humans
  • Hypertension, Pregnancy-Induced / physiopathology
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Pregnancy
  • Pregnant Women
  • Pulse Wave Analysis / methods
  • Ultrasonography, Doppler / methods
  • Vascular Resistance / physiology*