Finger Plethysmography to Predict Fluid Responsiveness in Healthy Pregnancy and Severe Preeclampsia

Finger Plethysmographic Cardiac Output Monitoring to Predict Fluid Responsiveness in Healthy Pregnancy and Women Diagnosed With Preeclampsia and Severe Features

The goal of this observational study is to determine whether noninvasive finger plethysmographic cardiac output monitoring can help predict fluid responsiveness in pregnant women, including those with preeclampsia with severe features.

The main questions it aims to answer are :

• Can changes in cardiac output measured by finger plethysmography predict fluid responsiveness?
• How does this method perform compared with standard echocardiographic assessment? Participants will provide consent and undergo noninvasive hemodynamic monitoring and a brief reversible physiological challenge.

Inclusion Criteria:

• Women diagnosed with preeclampsia with severe features following ACOG recommendations (systolic/diastolic BP >160/110 mmHg, proteinuria, or other severe features like headaches, visual disturbances, kidney/liver impairment, thrombocytopenia).
• Healthy pregnant women at term (for comparison group, e.g., scheduled for elective Cesarean delivery).

Exclusion Criteria:

• Patients who can not provide written consent to participate in the study
• BMI greater than 40 kg/m²
• Multiple pregnancy (twins, triplets, etc.)
• Non-reassuring fetal heart tracing
• ≤ 22 weeks gestation
• History of chronic arterial hypertension
• Chronic kidney disease
• Congenital or known acquired heart disease
• Chronic obstructive pulmonary disease
• Diabetes
• History of stroke
• Not tolerating passive leg raising (unable to be placed in the required study position)
• No TTE-windows
• Withdrawing consent
• Emergency cesarean delivery