The idea for this study is based on endothelial-dependent adaptation of hemodynamic circulation in pregnancy. The optimization of the circulatory component of the cardiovascular system (CVS) during pregnancy via blood pressure (BP), especially in physiological pregnancy (PhP), is accompanied by a clear overall increase in systolic characteristics of the pumping function of the heart. This orientation in cardiac output (CO) is unambiguously manifested throughout all three trimesters as with PhP—in a prone and standing position in total according to 24 characteristics out of 24 (P < 0.01), while for gestational endotheliopathy (PaP)—by 18 out of 24 (P < 0.05) clear restructuring of the dynamic organization of the circulatory state according to the anthropophysiological ratio to the hyperkinetic state according to CO in a standing position (type III) was noted with all blood pressure (BP) regimes. If the manifestation of type III under hypotonic, normotonic, and hypertonic regimes in BP was 8, 12, and 6%, respectively, then in the case of PhP, it was 21, 36, and 50%, respectively (P < 0.01), and for PaP, it was 48, 66, and 76% (P < 0.01). Hemodynamically identified heart failure (HF) syndrome, as the earliest preclinical circulatory endothelial-dependent form, is examined as a trigger of formation of perinatal pathology corresponding to preeclampsia.

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