| Low plasma volume following pregnancy complicated by pre-eclampsia predisposes for hypertensive disease in a next pregnancy. | |
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MedLine Citation:
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PMID: 14592585 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 110 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-10-31 Completed Date: 2003-12-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 1001-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, University Maastricht, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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 |
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