Peripartum colloid osmotic pressure changes: Effects of controlled fluid management

Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement

“…49 ) 3. Iatrogenic: increased interstitial fluid volume and/or uneven sequestering of excess interstitial fluid in the connective tissue spaces, often associated with; • delayed, ineffective, irregular, or infrequent early breastfeeding, with retention of expanding milk volume in the glandular compartment, crowding space within the breast and impeding return circulation through venous and lymphatic channels, 2,26 which in turn may become distended and offer further resistance against the draining of glandular/ductal tissue; • IV administration of crystalloid fluids for antepartum complications and/or intrapartum management, causing marked reduction of COP leading to rapid accumulation and retention of excess interstitial fluid; [36][37][38][39][40][41] • antidiuretic effects of pitocin (synthetic oxytocin), favoring water retention. 53 (The oxytocin molecule resembles the vasopressin (antidiuretic hormone) molecule and has the ability to bind to the vasopressin 2 receptor to cause an antidiuretic effect.…”

“…32 One force he explained is plasma colloid osmotic pressure (COP), determined by the concentration of plasma proteins, 35 which is one of the major factors regulating movement of fluid from the arterial end of the capillary into the interstitial space 36 and its eventual reentry into the venous end of the capillary. 33,37 COP normally declines in the first 24 hours after birth.…”

Alterations in Cardiopulmonary Physiology During Pregnancy

“…A further reduction in plasma COP occurs in the first 24 hours postpartum because of a number of factors, including blood loss, the administration of intravenous crystalloid, and the mobilization of extravascular fluid. [52][53][54] While the decrease in plasma COP increases the risk of developing pulmonary edema, this is relatively uncommon even in the presence of the markedly 204 depressed plasma COP levels noted in the postpartum period. [52][53][54] Nevertheless, it is important for the clinician to be aware that in states of reduced COP, as occur in pregnancy, the critical pulmonary capillary pressure at which pulmonary edema forms will be lowered.…”

“…[52][53][54] While the decrease in plasma COP increases the risk of developing pulmonary edema, this is relatively uncommon even in the presence of the markedly 204 depressed plasma COP levels noted in the postpartum period. [52][53][54] Nevertheless, it is important for the clinician to be aware that in states of reduced COP, as occur in pregnancy, the critical pulmonary capillary pressure at which pulmonary edema forms will be lowered. 55 An awareness of the normal cardiovascular physiological changes in pregnancy is necessary to correctly interpret clinical hemodynamic data.…”

Maternal intravenous fluids and postpartum breast changes: a pilot observational study

“…The effects of IV fluids given to mothers during labour have not been extensively studied, and there is limited research on the effects of IV fluids on postpartum breast engorgement or breast edema. Studies on postpartum engorgement failed to take IV fluids administered to mothers into account [ 9 , 11 , 12 ] and the one study found on postpartum edema failed to look at breast edema, but rather focused on peripheral edema [ 13 ].…”