The Relationship Between Intraabdominal Hypertension and Preeclampsia

Abstract

OBJECTIVE:We aimed to measure abdominal pressure and placental levels of malondialdehyde in patients with preeclampsia and investigate the relationship between intraabdominal pressure and clinical features of preeclampsia. STUDY DESIGN:Study was conducted at a tertiary referral clinic. Study group consisted of patients with preeclampsia and control group consisted of normotensive pregnant women. Both placental malondialdehyde and intraabdominal pressure levels were studied in all patients. Intraabdominal pressure was assessed indirectly via a Foley bladder catheter both antepartum and postpartum period. Statistical comparisons among groups were made using the Mann-Whitney U test, independent T test and Chisquare test. Statistical significance was set as p<0.05. RESULTS:Study and control group consisted of 35 pregnant patients. The mean patients' age, gravidity, parity, weight and BMI were not different between study and control groups. In the study group, Caesarean, preterm delivery and abdominal hypertension rate were significantly higher whereas the mean neonatal birth weight was lower. The mean antepartum and postpartum intraabdominal pressure levels were significantly higher in study group. The mean intraabdominal pressure was highest in patients with oliguria (19.8±1.8 cmH2O). Abdominal hypertension was detected in 30 (86%) patients in study group and in 3 (9%) patients in control group. The mean placental malondialdehyde level was significantly higher in patients with intraabdominal hypertension. CONCLUSIONS:Abdominal hypertension rate is very high in patients with preeclampsia. Abdominal hypertension may have an additional role in preeclampsia.

Intra‐abdominal pressure as an ignored parameter in the pathophysiology of preeclampsia

“…3 Interestingly, PE is associated with increased intra-abdominal pressure (IAP), irrespective of gestational age or birthweight, and correlates with maternal intestinal permeability and oliguria. 4,5 The paper by Arora et al in this issue confirms the association between PE and IAH but not the correlation with organ dysfunctions. 6 This discrepancy illustrates the need for a more in-depth exploration of the role of IAH in the pathophysiology of PE.…”

“…The study by Arora et al 6 further confirms the association between increased IAP and PE, which was previously reported in just two clinical studies. 4,5 It does not, however, answer the elusive chicken or egg question-that is, does high IAP cause PE, or do elevated IAPs occur as a result of the disease? Although more research is needed for such clarity, the current results provide other insights.…”

A case of preeclampsia developing massive ascites after delivery

“…Intraabdominal hypertension (IAH) is defined as a sustained IAP greater than 15 cmH 2 O. Antepartum IAP levels are thought to be significantly higher in patients with preeclampsia. 13 The abdominal cavity can be considered as a semi-closed compartment, and any volume change in abdominal content can affect IAP. An excessive elevated IAP before delivery and a significant dropped IAP after delivery might contribute to the predominant massive ascites two days after delivery.…”

“…Chun and Kirkpatrick 12 describe how term pregnancy and immediate postpartum phases may be associated with elevated IAP, which drops significantly after delivery. Intra‐abdominal hypertension (IAH) is defined as a sustained IAP greater than 15 cmH 2 O. Antepartum IAP levels are thought to be significantly higher in patients with preeclampsia 13 …”

Modern Aspects of Preeclampsia Etiology and Pathogenesis From the Intraabdominal Hypertension Syndrome Point of View

“…У досліджуваній та контрольній групі абдомінальна гіпертонія була виявлена у 30 (86%) та 3 (9%) пацієнтів відповідно. У висновках автори припускають, що абдомінальна гіпертензія може мати вплив на розвиток прееклампсії, тому що її частота дуже висока у пацієнтів з ПЕ [25].…”