MATERNAL HYPERTENSIVE DISORDERS AND FETAL CARDIOVASCULAR ADAPTATIONS: CLINICAL IMPLICATIONS AND LONG-TERM MANAGEMENT

Abstract

Maternal hypertensive disorders represent a significant complication during pregnancy and may include pre-eclampsia, eclampsia and gestational hypertension. These conditions are associated with physiological changes that impact not only maternal health but also fetal development, especially with regard to cardiovascular adaptations. During pregnancy, the fetus depends entirely on the maternal cardiovascular system for adequate supply of nutrients and oxygen. Any compromise in this system can result in adverse repercussions on fetal development, potentially influencing the child's long-term cardiovascular health. Objective: This systematic literature review aims to analyze and synthesize recent studies on the effects of maternal hypertensive disorders on fetal cardiovascular adaptations, highlighting immediate clinical implications and considerations for long-term management. Methodology: The review followed the PRISMA guidelines. The search was conducted in the PubMed, Scielo and Web of Science databases, using the descriptors "hypertensive disorders in pregnancy", "fetal cardiovascular adaptations", "long-term implications", "clinical management", and "systematic review". The inclusion criteria were studies published in the last 10 years, focused on humans, with full texts available and written in English, Spanish or Portuguese. Exclusion criteria included studies with unrepresentative samples, narrative reviews, and those without data on fetal cardiovascular adaptations. Results: The analysis of the studies revealed that maternal hypertensive disorders are often associated with changes in the hemodynamic and structural parameters of the fetus, including changes in vascular resistance, placental blood flow and cardiac development. These adaptations can predispose the fetus to neonatal complications and increase the risk of cardiovascular diseases in adulthood. Conclusion: Understanding these mechanisms is crucial for the clinical management of pregnancies affected by hypertension, allowing preventive interventions and adequate monitoring to mitigate the long-term impact on the cardiovascular health of the offspring.