• Laura K Vricella, Judette M Louis, Edward Chien, and Brian M Mercer.
• Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, OH; Department of Obstetrics and Gynecology, Mercy Hospital, St Louis, MO. Electronic address: lpvricella@gmail.com.
• Am. J. Obstet. Gynecol. 2015 Sep 1; 213 (3): 408.e1-6.

ObjectiveThe impact of obesity on maternal blood volume in pregnancy has not been reported. We compared the blood volumes of obese and normal-weight gravidas using a validated hydroxyethyl starch (HES) dilution technique for blood volume estimation.Study DesignBlood volumes were estimated in 30 normal-weight (pregravid body mass index [BMI] <25 kg/m(2)) and 30 obese (pregravid BMI >35 kg/m(2)) gravidas >34 weeks' gestation using a modified HES dilution technique. Blood samples obtained before and 10 minutes after HES injection were analyzed for plasma glucose concentrations after acid hydrolysis of HES. Blood volume was calculated from the difference between glucose concentrations measured in hydrolyzed plasma.ResultsObese gravidas had higher pregravid and visit BMI (mean [SD]): pregravid (41 [4] vs 22 [2] kg/m(2), P = .001); visit (42 [4] vs 27 [2] kg/m(2), P = .001), but lower weight gain (5 [7] vs 12 [4] kg, P = .001) than normal-weight women. Obese gravidas had similar estimated total blood volume to normal-weight women (8103 ± 2452 vs 6944 ± 2830 mL, P = .1), but lower blood volume per kilogram weight (73 ± 22 vs 95 ± 30 mL/kg, P = .007).ConclusionObese gravidas have similar circulating blood volume, but lower blood volume per kilogram body weight, than normal-weight gravidas near term.Copyright © 2015 Elsevier Inc. All rights reserved.

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