American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Oct 1984
Hemodynamic measurements in preeclampsia: preliminary observations.
Ten patients with preeclampsia were monitored with a Swan-Ganz thermodilution catheter before the start of treatment. Reference data were obtained by right-heart catheterization in four normal pregnant women. In the preeclamptic group the effects of volume expansion and vasodilatation were studied. ⋯ Vasodilatation with dihydralazine resulted in a further decrease in systemic vascular resistance, a fall in blood pressure accompanied by a further increase in cardiac index with a stable pulmonary capillary wedge pressure. It is concluded that pregnant women with preeclampsia are unable to cope with a circulating volume necessary to maintain a cardiac index and ventricular filling pressure which is considered to be physiologic in normal pregnancy. In preeclampsia the capacity for vasodilatation is inadequate.
-
Am. J. Obstet. Gynecol. · Jul 1984
Clinical TrialControl of preeclamptic hypertension by ketanserin, a new serotonin receptor antagonist.
We investigated the effect of peripheral serotonin receptor blockade on preeclamptic hypertension in 20 postpartum patients by the use of ketanserin, a serotonin receptor antagonist. In a study consisting of a double-blind crossover with placebo, parenteral ketanserin significantly reduced blood pressure from 167/105 to 126/71 mm Hg compared to a decline from 157/98 to 150/91 mm Hg for the placebo (p less than 0.001). ⋯ Side effects were minimal. The results demonstrate that preeclamptic hypertension can be controlled by ketanserin and suggest that serotonin may have a role in the modulation of preeclampsia.
-
Am. J. Obstet. Gynecol. · May 1984
Comparative StudyIntrapartum to postpartum changes in colloid osmotic pressure.
A study was undertaken to determine the effect of route of delivery on plasma colloid osmotic pressure. Plasma colloid osmotic pressure was measured on admission to the hospital and 8 to 24 hours post partum in 72 patients at term with uncomplicated prenatal histories. Thirty-six patients underwent uncomplicated vaginal deliveries (local anesthesia, 18; conduction anesthesia, 18) and 36 patients had cesarean sections (conduction anesthesia, 18; general anesthesia, 18). ⋯ Furthermore, the mean reductions in colloid osmotic pressure when all four groups were compared by type of anesthesia were not significantly different. Fifteen patients (20.8%) in the study had a postpartum colloid osmotic pressure of less than 13.6 mm Hg, and five (6.9%) had a postpartum colloid pressure of less than 12.5 mm Hg. Our results indicate that, for normal pregnancy, colloid osmotic pressure is uniformly lowered in the post partum and, in some cases, to levels that have been reported to be dangerously low.