Capillary Permeability and Extracellular Fluid Volumes in Pregnancy-Induced Hypertension

Abstract

1. Capillary permeability was determined by the disappearance rate of Evans Blue dye from plasma in healthy non-pregnant women, normal third-trimester primigravidae and primigravidae with pregnancy-induced hypertension. 2. Extracellular fluid volume was determined from the disappearance curves of injected mannitol in the same subjects and the plasma volume was measured by the Evans Blue dye dilution technique. 3. In normal pregnancy capillary permeability was not altered from that of non-pregnant subjects. Although extracellular fluid volume and plasma volume were increased in normal pregnant compared with non-pregnant women, the distribution of fluid between plasma volume and interstitial fluid volume was unaltered. 4. Women with established pregnancy-induced hypertension had a more rapid Evans Blue disappearance rate and a lower plasma volume than normal pregnant women, independent of the presence of proteinuria. Maternal plasma volume correlated positively and significantly with fetal birth weight in women with pregnancy-induced hypertension, emphasizing the important relationship between maternal plasma volume and fetal outcome. 5. The increased capillary permeability in women with pregnancy-induced hypertension was associated with a reduction in the plasma volume/interstitial fluid volume ratio but a normal extracellular fluid volume, suggesting that the reduced plasma volume did not result from sodium loss but rather from a redistribution of the total extracellular fluid volume. These changes did not differ significantly in subgroups with and without oedema.

Hypertension in pregnancy

“…Interestingly, in PE the total extracellular fluid volume (ECFV) is unchanged, so that the ratio of plasma volume: ECFV is significantly reduced compared with normal pregnancy, 137 presumably in association with a 'leaky' circulation. 139 There is a small fall in systolic, and a greater fall in diastolic blood pressure during the first half of pregnancy in both normal and future hypertensive women (eg, Christianson, 1976 140 ; Halligan et al, 1993 141 ). It is important that the blood pressure be recorded at the first antenatal clinic visit to give the base against which subsequent change can be assessed (see: Definitions).…”

Differential Expression of Placenta Growth Factors and Their Receptors In the Normal and Pregnancy-Induced Hypertensive Human Placentas

“…There are also an increased concentration of vasoconstrictive agents such as endothelin (3), increased capillary permeability (4), and the endothelial damage is also associated with neutrophil (5).…”

Serious Influence of Yersinia Enterocolitis on Pregnancy in a Woman Complicated With Chronic Hypertension and Gestational Diabetes Mellitus: A Case Report

“…The exact pathophysiological mechanisms underlying ascites in PIH remain unclear, but renal retention of sodium and water and retention of water in the extravascular space are involved. In PIH, there is extensive vascular endothelial malfunction throughout the body, encouraging water leakage from the capillaries and unpredictable protein leakage causing decreased intravascular colloid oncotic pressure and exacerbated ascites [10]. Association of hypoprotenemia as well as hypoalbuminemia with massive ascites in severe preeclampsia was reported [9,11].…”