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Preterm preeclampsia (PE), occurring at < 37 weeks' gestation, can be predicted from as early as 11-13 weeks and prevented with the use of aspirin. In contrast, term PE, which is more common than preterm-PE and it can be associated with important maternal morbidity and mortality, cannot be effectively predicted at 11-13 weeks and cannot be prevented by the prophy-lactic use of aspirin. This paper briefly reviews the pathogenesis of term PE and discusses strategies available for its prediction.

What are the novel findings of this work?At 19-23 weeks' gestation, twin compared with singleton pregnancy is associated with an increase in cardiac output and reduction in left ventricular systolic and diastolic Doppler function. Cardiac changes are more accentuated in dichorionic compared with monochorionic twin pregnancies. What are the clinical implications of this work?Maternal cardiovascular adaptations seen in midgestation in twin pregnancy resemble those encountered in singleton pregnancy later in gestation and are mostly related to changes in loading conditions. These findings support the plasticity of the maternal cardiovascular system and its increased ability for remodeling in response to volume loading, without evidence of decompensation.