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Journal of the Society for Gynecologic Investigation, Vol. 13, No. 1, 48-52 (2006)
DOI: 10.1016/j.jsgi.2005.11.003

Low Plasma Volume Coincides With Sympathetic Hyperactivity and Reduced Baroreflex Sensitivity In Formerly Preeclamptic Patients

Dorette A. Courtar, MD

Department of Obstetrics and Gynecology, University Hospital Maastricht, Maastricht, The Netherlands; Department of Obstetrics and Gynecology, St. Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands dorette.courtar{at}ogu.unimaas.nl

Marc E.A. Spaanderman, MD, PhD

Robert Aardenburg, MD

Ben J.A. Janssen, PhD

Louis L.H. Peeters, MD, PhD

Department of Obstetrics and Gynecology, University Hospital Maastricht, Maastricht, The Netherlands; Department of Obstetrics and Gynecology, St. Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands; Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands

Background: Preeclampsia is associated with enhanced sympathetic activity as well as subnormal plasma volume. Meanwhile, in over 50% of these complicated pregnancies, the subnormal plasma volume has been found to persist for a prolonged period after pregnancy. The objective of this study is to test the hypothesis that in normotensive formerly-preeclamptic women, persistence of a subnormal plasma volume coincides with enhanced sympathetic activity and with it, an altered autonomic control of blood pressure.

Methods: Forty-eight formerly-preeclamptic women participated in this study. After measurement of their plasma volume by iodine 125-albumin indicator dilution, they were subdivided into a group with a normal plasma volume (plasma volume > 48 ml/kg lean body mass) and a group with a subnormal plasma volume (≤48 ml/kg lean body mass). We performed spectral analysis on their beat-to-beat blood pressure and heart rate recordings and compared both groups using non-parametric tests.

Results: Formerly-preeclamptic women with a subnormal plasma volume had a higher sympathetic activity (P = .001) and a lower baroreflex sensitivity (P = .04) than their counterparts with a normal plasma volume.

Conclusion: In normotensive formerly-preeclamptic women, a subnormal plasma volume coincides with a higher sympathetic activity in the blood pressure regulation and lower baroreflex sensitivity. Whether these alterations in the autonomic control mechanisms are a cause or effect of the subnormal plasma volume remains to be elucidated.

Key Words: Plasma volume • autonomic function • blood pressure • preeclampsia • spectral analysis


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