Hemodilution and pre-eclampsia

Abstract

Pre - eclampsia is the development of hypertension and proteinuria after the 20th week of gestation. The most common causes of increased peripheral resistance are vasoconstriction and hemoconcentration with plasma volume contraction.

Additional rheological parameters are increased red blood cell aggregation and impaired erythrocyte deformability. Preeclamptic patients showed a significantly reduced cardiac output and central venous pressure compared with normal pregnant women. It has already been shown in the studies by Garn et al. (2) and also in subsequent studies Murphy et al. (15) and Knottnerus et al (12) that a strong correlation exists between newborn weight and plasma volume. Other authors (4,16) conclude that plasma volume contraction may plays an even larger role than vasoconstriction in the pathogenesis of the fetal growth retardation that often accompanies maternal hypertension. This view is supported by the finding that hypertension and perinatal complications can be reduced in some pregnant women by the administration of oncotic solutions (i.e. hydroxyethyl-starch) that expand plasma volume.