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A Subnormal Plasma Volume in Formerly Preeclamptic Women is Associated with a Low Venous Capacitance

Departments of Obstetnrcs and Gynecology, and Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands; Department of Obstetrics and Gynecology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands; R.Aardenburg{at}og.unimaas.nl

Marc E. Spaanderman, MD, PhD

Dorette A. Courtar, MD

Hugo W. van Eijndhoven, MD

Peter W. de Leeuw, MD, PhD

Louis L. Peeters, MD, PhD

Departments of Obstetnrcs and Gynecology, and Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands

Objective: Pregnancy induces a smaller rise in plasma volume in formerly preeclamptic women with a pre-existent subnormal plasma volume than in their counterparts with a normal plasma volume. These women also have a three times higher recurrence rate of pregnancy-induced hypertensive disorders. In this study we tested the hypothesis that a subnormal plasma volume in these women is related to a lower capacitance of their venous compartment.

Methods: In 31 nonpregnant formerly preeclamptic-women with a subnormal plasma volume and eight parous controls, we infused intravenously 500 mL of a modified gelatin solution over 30 minutes. Before and after infusion we measured the circulating levels of -atrial natriuretic peptide (-ANP) and active plasma renin concentration (APRC). During volume loading, we recorded the change in heart rate, stroke volume, and cardiac output using pulse contour analysis. We measured the ratio of percent change in blood volume and percent change in cardiac output during volume loading as a marker for venous capacitance.

Results: During volume loading, patients differed from controls by a larger rise in -ANP, pulse rate, and cardiac output, and by a lower estimated venous capacitance. The concomitant response of stroke volume and APRC did not differ appreciably between groups.

Conclusion: Formerly preeclamptic women with a subnormal plasma volume differ from controls with a normal plasma volume by a reduced venous capacitance. These results support our hypothesis that, in these women, a subnornal plasma volume indicates the presence of a subnormal venous capacitance.

Key Words: Preeclampsia • plasma volume • venous capacitance • pregnancy

Journal of the Society for Gynecologic Investigation, Vol. 12, No. 2, 107-111 (2005)
DOI: 10.1016/j.jsgi.2004.09.002


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