Document Detail


Low plasma volume following pregnancy complicated by pre-eclampsia predisposes for hypertensive disease in a next pregnancy.
MedLine Citation:
PMID:  14592585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: A large number of women with a history of pre-eclampsia/HELLP have a low plasma volume at least six months postpartum. The objective of this study was to determine whether a low plasma volume in formerly pre-eclamptic women and HELLP patients is associated with an increased risk for recurrent hypertensive complications in a next pregnancy. DESIGN: Prospective observational study. SETTING: Tertiary obstetric centre. SAMPLE: Formerly pre-eclamptic women and controls. METHODS: In 316 women with a history of pre-eclampsia and/or HELLP, we measured, plasma volume along with haemodynamic, metabolic and haemostatic variables at least six months postpartum. A group of 22 healthy parous controls was used as a reference. After standardising plasma volume for body mass index, women were subdivided into normotensive and normal plasma volume (n = 199), normotensive and low plasma volume (n = 76) and hypertensive (n = 41) subgroups, which were compared for demography, clinical parameters and course of a next pregnancy. MAIN OUTCOME MEASURES: Recurrent hypertensive disease of pregnancy. RESULTS: Relative to the normal plasma volume subgroup, normotensive women in the low plasma volume subgroup have a higher body mass index, a lower total vascular compliance and a shorter estimated systemic circulation time. They have a higher HOMA index and higher fasting triglyceride levels. In normotensive and hypertensive former patients alike, low plasma volume is associated with a higher recurrence of hypertensive complications in a next pregnancy compared with normotensive women with normal plasma volume. CONCLUSION: Low plasma volume in normotensive women with a history of pre-eclampsia and/or HELLP is associated with overweight, reduced vascular compliance and insulin resistance and a predisposition for recurrent pre-eclampsia and HELLP syndrome in a next pregnancy.
Authors:
Robert Aardenburg; Marc E A Spaanderman; Timo H Ekhart; Hugo W van Eijndhoven; Olivier W H van der Heijden; Louis L H Peeters
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  110     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-31     Completed Date:  2003-12-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1001-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, University Maastricht, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
HELLP Syndrome / physiopathology*
Hemodynamics / physiology
Humans
Hypertension / etiology*
Parity
Plasma Volume / physiology*
Pre-Eclampsia / physiopathology*
Pregnancy
Pregnancy Complications, Cardiovascular / etiology*
Prospective Studies
Recurrence
Regression Analysis

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


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