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The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study.
Ultrasound Obstet Gynecol. 2004 Apr; 23(4):327-32.UO

Abstract

OBJECTIVES

To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia.

METHODS

In 13 pre-eclamptic women maternal and fetal hemodynamics were established by means of combined measurement of maternal arterial blood pressure (BP), WBV, hematocrit and uterine artery (UtA) resistance index (RI) in addition to umbilical artery (UA) pulsatility index (PI) and UV volume flow obtained from UV vessel area and UV time-averaged flow velocity. In each woman all parameters were measured four times at baseline, after PVE, after DH and 24 h after the start of treatment.

RESULTS

Maternal diastolic BP, hematocrit and WBV display a significant reduction after PVE. In the fetus UA PI decreases significantly whereas a significant increase in UV cross-sectional area was detected. After maternal DH administration, arterial systolic and diastolic BP and UA PI show a significant decrease compared with the measurements following PVE. At 24 h, only maternal systolic and diastolic BP display a significant further decrease. No significant changes were established for the UtA RI, UV time-averaged velocity and UV volume flow during the entire study period.

CONCLUSIONS

During pre-eclampsia, maternal PVE followed by DH administration results in a significant reduction in maternal diastolic BP, maternal hematocrit and WBV. Maternal PVE is associated with a significant increase in UV cross-sectional area and a non-significant rise of 11% in UV volume flow. Maternal DH administration does not result in any change in UV cross-sectional area. However, UA PI decreases significantly after both PVE and DH treatment.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15065180

Citation

Boito, S M E., et al. "The Impact of Maternal Plasma Volume Expansion and Antihypertensive Treatment With Intravenous Dihydralazine On Fetal and Maternal Hemodynamics During Pre-eclampsia: a Clinical, echo-Doppler and Viscometric Study." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 23, no. 4, 2004, pp. 327-32.
Boito SM, Struijk PC, Pop GA, et al. The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study. Ultrasound Obstet Gynecol. 2004;23(4):327-32.
Boito, S. M., Struijk, P. C., Pop, G. A., Visser, W., Steegers, E. A., & Wladimiroff, J. W. (2004). The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 23(4), 327-32.
Boito SM, et al. The Impact of Maternal Plasma Volume Expansion and Antihypertensive Treatment With Intravenous Dihydralazine On Fetal and Maternal Hemodynamics During Pre-eclampsia: a Clinical, echo-Doppler and Viscometric Study. Ultrasound Obstet Gynecol. 2004;23(4):327-32. PubMed PMID: 15065180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study. AU - Boito,S M E, AU - Struijk,P C, AU - Pop,G A M, AU - Visser,W, AU - Steegers,E A P, AU - Wladimiroff,J W, PY - 2004/4/6/pubmed PY - 2004/8/24/medline PY - 2004/4/6/entrez SP - 327 EP - 32 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 23 IS - 4 N2 - OBJECTIVES: To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia. METHODS: In 13 pre-eclamptic women maternal and fetal hemodynamics were established by means of combined measurement of maternal arterial blood pressure (BP), WBV, hematocrit and uterine artery (UtA) resistance index (RI) in addition to umbilical artery (UA) pulsatility index (PI) and UV volume flow obtained from UV vessel area and UV time-averaged flow velocity. In each woman all parameters were measured four times at baseline, after PVE, after DH and 24 h after the start of treatment. RESULTS: Maternal diastolic BP, hematocrit and WBV display a significant reduction after PVE. In the fetus UA PI decreases significantly whereas a significant increase in UV cross-sectional area was detected. After maternal DH administration, arterial systolic and diastolic BP and UA PI show a significant decrease compared with the measurements following PVE. At 24 h, only maternal systolic and diastolic BP display a significant further decrease. No significant changes were established for the UtA RI, UV time-averaged velocity and UV volume flow during the entire study period. CONCLUSIONS: During pre-eclampsia, maternal PVE followed by DH administration results in a significant reduction in maternal diastolic BP, maternal hematocrit and WBV. Maternal PVE is associated with a significant increase in UV cross-sectional area and a non-significant rise of 11% in UV volume flow. Maternal DH administration does not result in any change in UV cross-sectional area. However, UA PI decreases significantly after both PVE and DH treatment. SN - 0960-7692 UR - https://www.unboundmedicine.com/medline/citation/15065180/The_impact_of_maternal_plasma_volume_expansion_and_antihypertensive_treatment_with_intravenous_dihydralazine_on_fetal_and_maternal_hemodynamics_during_pre_eclampsia:_a_clinical_echo_Doppler_and_viscometric_study_ L2 - https://doi.org/10.1002/uog.1012 DB - PRIME DP - Unbound Medicine ER -