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Modelling maternal cardiovascular adaptation to pregnancy: a scoping review

Kathryn Hunt, Yannis Polydoros, Raoul van Loon Orcid Logo, Rosemary C Townsend, Rebecca M Reynolds

BMC Pregnancy and Childbirth

Swansea University Authors: Yannis Polydoros, Raoul van Loon Orcid Logo

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DOI (Published version): 10.1186/s12884-025-08270-z

Abstract

Background: The maternal cardiovascular system undergoes a profound transformation during pregnancy. Disordered cardiovascular adaptation is associated with pre-eclampsia and fetal growth restriction; however, these complications remain challenging to predict and manage. Computational modelling pres...

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Published in: BMC Pregnancy and Childbirth
ISSN: 1471-2393
Published: Springer Nature 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa71108
first_indexed 2025-12-08T11:01:08Z
last_indexed 2025-12-09T14:20:20Z
id cronfa71108
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Disordered cardiovascular adaptation is associated with pre-eclampsia and fetal growth restriction; however, these complications remain challenging to predict and manage. Computational modelling presents an opportunity to study the maternal circulation with unprecedented flexibility. We conducted a scoping review to assess the potential utility of computational models for studying maternal cardiovascular adaptation to pregnancy and providing insights into disease. We aimed to identify research gaps and barriers to translating this emerging field into clinical practice. Methods: Medline, Embase, and Web of Science Core Collection were searched from 01/01/2013 to 01/09/2025, for articles related to computational haemodynamic models of pregnancy. English-language studies describing models of the maternal circulation in human pregnancy were identified. Information on system modelled, study design, participant or clinical specimen details, and key findings were extracted from original research studies and presented in a narrative synthesis. Results: Of 662 citations, 37 met inclusion criteria, comprising 28 original research studies, two conference abstracts, and seven reviews. Amongst the original research studies, 27 were basic experimental papers and one was a retrospective cohort study. Nine experimental articles incorporated data from pregnant participants or clinical specimens into personalised models, with sample sizes between one and 21. Four of these included participants or specimens affected by hypertensive disorders of pregnancy or fetal growth restriction. The retrospective cohort study employed haemodynamic modelling to investigate blood loss in 480 patients with abnormally invasive placentas. Modelling approaches described included those simulating the entire maternal circulation, maternal cardiac remodelling, maternal renal autoregulation, the maternal pelvic circulation in isolation, uterine vascular adaptation, spiral artery remodelling, and blood flows within the placental intervillous space. Conclusions: Computational modelling could represent a powerful tool to advance understanding of maternal cardiovascular adaptation to pregnancy and guide future approaches to risk stratification, diagnosis, and management of pregnancy complications. Realising this promise will require cardiovascular models to be parameterised with scalable metrics, validated in large pregnancy cohorts, developed alongside robust computational processing pipelines, and integrated into existing clinical workflows. 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IP, RL, RT &amp; RR receive funding from the Wellcome Leap In Utero program.</funders><projectreference/><lastEdited>2025-12-08T11:02:20.7916066</lastEdited><Created>2025-12-08T10:55:40.5307092</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Biomedical Engineering</level></path><authors><author><firstname>Kathryn</firstname><surname>Hunt</surname><order>1</order></author><author><firstname>Yannis</firstname><surname>Polydoros</surname><order>2</order></author><author><firstname>Raoul</firstname><surname>van Loon</surname><orcid>0000-0003-3581-5827</orcid><order>3</order></author><author><firstname>Rosemary C</firstname><surname>Townsend</surname><order>4</order></author><author><firstname>Rebecca M</firstname><surname>Reynolds</surname><order>5</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2025-12-08T11:02:20.7916066 v2 71108 2025-12-08 Modelling maternal cardiovascular adaptation to pregnancy: a scoping review 93fcefc8f0de1a0efad45402322bfc45 Yannis Polydoros Yannis Polydoros true false 880b30f90841a022f1e5bac32fb12193 0000-0003-3581-5827 Raoul van Loon Raoul van Loon true false 2025-12-08 EAAS Background: The maternal cardiovascular system undergoes a profound transformation during pregnancy. Disordered cardiovascular adaptation is associated with pre-eclampsia and fetal growth restriction; however, these complications remain challenging to predict and manage. Computational modelling presents an opportunity to study the maternal circulation with unprecedented flexibility. We conducted a scoping review to assess the potential utility of computational models for studying maternal cardiovascular adaptation to pregnancy and providing insights into disease. We aimed to identify research gaps and barriers to translating this emerging field into clinical practice. Methods: Medline, Embase, and Web of Science Core Collection were searched from 01/01/2013 to 01/09/2025, for articles related to computational haemodynamic models of pregnancy. English-language studies describing models of the maternal circulation in human pregnancy were identified. Information on system modelled, study design, participant or clinical specimen details, and key findings were extracted from original research studies and presented in a narrative synthesis. Results: Of 662 citations, 37 met inclusion criteria, comprising 28 original research studies, two conference abstracts, and seven reviews. Amongst the original research studies, 27 were basic experimental papers and one was a retrospective cohort study. Nine experimental articles incorporated data from pregnant participants or clinical specimens into personalised models, with sample sizes between one and 21. Four of these included participants or specimens affected by hypertensive disorders of pregnancy or fetal growth restriction. The retrospective cohort study employed haemodynamic modelling to investigate blood loss in 480 patients with abnormally invasive placentas. Modelling approaches described included those simulating the entire maternal circulation, maternal cardiac remodelling, maternal renal autoregulation, the maternal pelvic circulation in isolation, uterine vascular adaptation, spiral artery remodelling, and blood flows within the placental intervillous space. Conclusions: Computational modelling could represent a powerful tool to advance understanding of maternal cardiovascular adaptation to pregnancy and guide future approaches to risk stratification, diagnosis, and management of pregnancy complications. Realising this promise will require cardiovascular models to be parameterised with scalable metrics, validated in large pregnancy cohorts, developed alongside robust computational processing pipelines, and integrated into existing clinical workflows. Protocol registration: The review protocol was registered prospectively with the Open Science Framework (osf.io/v3968). Journal Article BMC Pregnancy and Childbirth 0 Springer Nature 1471-2393 Pregnancy; Cardiovascular dysfunction; Computational modelling; Digital twins; Pre-eclampsia; Fetal growth restriction 24 11 2025 2025-11-24 10.1186/s12884-025-08270-z COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee KH is funded by a British Heart Foundation Research Excellence Award (RE/18/5/34216). IP, RL, RT & RR receive funding from the Wellcome Leap In Utero program. 2025-12-08T11:02:20.7916066 2025-12-08T10:55:40.5307092 Faculty of Science and Engineering School of Engineering and Applied Sciences - Biomedical Engineering Kathryn Hunt 1 Yannis Polydoros 2 Raoul van Loon 0000-0003-3581-5827 3 Rosemary C Townsend 4 Rebecca M Reynolds 5
title Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
spellingShingle Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
Yannis Polydoros
Raoul van Loon
title_short Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
title_full Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
title_fullStr Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
title_full_unstemmed Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
title_sort Modelling maternal cardiovascular adaptation to pregnancy: a scoping review
author_id_str_mv 93fcefc8f0de1a0efad45402322bfc45
880b30f90841a022f1e5bac32fb12193
author_id_fullname_str_mv 93fcefc8f0de1a0efad45402322bfc45_***_Yannis Polydoros
880b30f90841a022f1e5bac32fb12193_***_Raoul van Loon
author Yannis Polydoros
Raoul van Loon
author2 Kathryn Hunt
Yannis Polydoros
Raoul van Loon
Rosemary C Townsend
Rebecca M Reynolds
format Journal article
container_title BMC Pregnancy and Childbirth
container_volume 0
publishDate 2025
institution Swansea University
issn 1471-2393
doi_str_mv 10.1186/s12884-025-08270-z
publisher Springer Nature
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Biomedical Engineering{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Biomedical Engineering
document_store_str 0
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description Background: The maternal cardiovascular system undergoes a profound transformation during pregnancy. Disordered cardiovascular adaptation is associated with pre-eclampsia and fetal growth restriction; however, these complications remain challenging to predict and manage. Computational modelling presents an opportunity to study the maternal circulation with unprecedented flexibility. We conducted a scoping review to assess the potential utility of computational models for studying maternal cardiovascular adaptation to pregnancy and providing insights into disease. We aimed to identify research gaps and barriers to translating this emerging field into clinical practice. Methods: Medline, Embase, and Web of Science Core Collection were searched from 01/01/2013 to 01/09/2025, for articles related to computational haemodynamic models of pregnancy. English-language studies describing models of the maternal circulation in human pregnancy were identified. Information on system modelled, study design, participant or clinical specimen details, and key findings were extracted from original research studies and presented in a narrative synthesis. Results: Of 662 citations, 37 met inclusion criteria, comprising 28 original research studies, two conference abstracts, and seven reviews. Amongst the original research studies, 27 were basic experimental papers and one was a retrospective cohort study. Nine experimental articles incorporated data from pregnant participants or clinical specimens into personalised models, with sample sizes between one and 21. Four of these included participants or specimens affected by hypertensive disorders of pregnancy or fetal growth restriction. The retrospective cohort study employed haemodynamic modelling to investigate blood loss in 480 patients with abnormally invasive placentas. Modelling approaches described included those simulating the entire maternal circulation, maternal cardiac remodelling, maternal renal autoregulation, the maternal pelvic circulation in isolation, uterine vascular adaptation, spiral artery remodelling, and blood flows within the placental intervillous space. Conclusions: Computational modelling could represent a powerful tool to advance understanding of maternal cardiovascular adaptation to pregnancy and guide future approaches to risk stratification, diagnosis, and management of pregnancy complications. Realising this promise will require cardiovascular models to be parameterised with scalable metrics, validated in large pregnancy cohorts, developed alongside robust computational processing pipelines, and integrated into existing clinical workflows. Protocol registration: The review protocol was registered prospectively with the Open Science Framework (osf.io/v3968).
published_date 2025-11-24T05:28:05Z
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