Low plasma volume following pregnancy complicated by pre-eclampsia predisposes for hypertensive disease in a next pregnancy

被引:40
作者
Aardenburg, R [1 ]
Spaanderman, MEA [1 ]
Ekhart, TH [1 ]
van Eijndhoven, HW [1 ]
van der Heijden, OWH [1 ]
Peeters, LLH [1 ]
机构
[1] Univ Maastricht, Dept Obstet & Gynaecol, NL-6202 AZ Maastricht, Netherlands
关键词
D O I
10.1016/S1470-0328(03)02536-9
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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.
引用
收藏
页码:1001 / 1006
页数:6
相关论文
共 25 条
[1]   Reactive oxygen species are involved in smoking-induced dysfunction of nitric oxide biosynthesis and upregulation of endothelial nitric oxide synthase - An in vitro demonstration in human coronary artery endothelial cells [J].
Barua, RS ;
Ambrose, JA ;
Srivastava, S ;
DeVoe, MC ;
Eales-Reynolds, LJ .
CIRCULATION, 2003, 107 (18) :2342-2347
[2]   Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity - Studies in subjects with various degrees of glucose tolerance and insulin sensitivity [J].
Bonora, E ;
Saggiani, F ;
Targher, G ;
Zenere, MB ;
Alberiche, M ;
Monauni, T ;
Bonadonna, RC ;
Muggeo, M .
DIABETES CARE, 2000, 23 (01) :57-63
[3]   WHEN DO CARDIOVASCULAR PARAMETERS RETURN TO THEIR PRECONCEPTION VALUES [J].
CAPELESS, EL ;
CLAPP, JF .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1991, 165 (04) :883-886
[4]   NON-PREGNANT MATERNAL PLASMA-VOLUME AND FETAL GROWTH RETARDATION [J].
CROALL, J ;
SHERRIF, S ;
MATTHEWS, J .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1978, 85 (02) :90-95
[5]   Preeclampsia and genetic risk factors for thrombosis: A case-control study [J].
De Groot, CJM ;
Bloemenkamp, KWM ;
Duvekot, EJ ;
Helmerhorst, FM ;
Bertina, RM ;
Van der Meer, F ;
De Ronde, H ;
Oei, SG ;
Kanhai, HHH ;
Rosendaal, FR .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1999, 181 (04) :975-980
[6]   UNDERLYING DISORDERS ASSOCIATED WITH SEVERE EARLY-ONSET PREECLAMPSIA [J].
DEKKER, GA ;
DEVRIES, JIP ;
DOELITZSCH, PM ;
HUIJGENS, PC ;
VONBLOMBERG, BME ;
JAKOBS, C ;
VANGEIJN, HP .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1995, 173 (04) :1042-1048
[7]  
DUVEKOT JJ, 1994, BASIC RES CARDIOL, V89, P270
[8]   Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy [J].
Gifford, RW ;
August, PA ;
Cunningham, G ;
Green, LA ;
Lindheimer, MD ;
McNellis, D ;
Roberts, JM ;
Sibai, BM ;
Taler, SJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2000, 183 (01) :S1-S22
[9]   MATERNAL PLASMA-VOLUME AND DISORDERS OF PREGNANCY [J].
GOODLIN, RC .
BRITISH MEDICAL JOURNAL, 1984, 288 (6428) :1454-1455
[10]   Cardiovascular disease in diabetes mellitus type 2: a potential role for novel cardiovascular risk factors [J].
Hayden, JM ;
Reaven, PD .
CURRENT OPINION IN LIPIDOLOGY, 2000, 11 (05) :519-528