Document Detail

Blood rheology and pregnancy.
MedLine Citation:
PMID:  3327565     Owner:  NLM     Status:  MEDLINE    
Pregnancy is a hypervolaemic situation with early expanded plasma volume, a high cardiac output and a decrease in the vascular and rheological resistance. The increase in plasma volume correlates better with fetal size than maternal size. The hypervolaemic and vasodilated state that accompanies normal pregnancy results in a high flow in the uterine arteries. In contrast, patients with PIH (pregnancy-induced hypertension) or placental insufficiency may have a contracted plasma volume secondary to diffuse vasoconstriction. In spite of the intense vasospasm and hypovolaemia, pre-eclampsia has generally a cardiac output which may be equal, higher or lower compared with non-eclamptic pregnancy. Hypovolaemia is reflected in a higher haematocrit than normal. In the case of a hypovolaemic state, haemoconcentration is associated with high red cell aggregation. In fetal distress and severe PIH, the rheological status (haemoconcentration and elevated red cell aggregation) has a high predictive value for perinatal complications. In patients with severe PIH, erythrocyte filtration is impaired. The increased leukocyte count in patients with PIH may occlude small vessels and could be a factor impairing intervillous blood flow. The increased erythrocyte rigidity may result from a re-distribution of cellular calcium metabolism (Blaustein concept). We conclude that there is an optimal haematocrit during pregnancy between 30% and 38%. The presence of a high haematocrit and in addition elevated red cell aggregation should alert the physician to an increased risk of fetal compromise.
L Heilmann
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Baillière's clinical haematology     Volume:  1     ISSN:  0950-3536     ISO Abbreviation:  Baillieres Clin. Haematol.     Publication Date:  1987 Sep 
Date Detail:
Created Date:  1988-05-02     Completed Date:  1988-05-02     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8800474     Medline TA:  Baillieres Clin Haematol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  777-99     Citation Subset:  IM    
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MeSH Terms
Blood Flow Velocity
Blood Viscosity*
Pregnancy / blood,  physiology*
Pregnancy Complications, Hematologic / blood,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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