Maternal and fetal colloid osmotic pressure following fluid expansion during cesarean section. 1995

M A Hauch, and R R Gaiser, and B L Hartwell, and S Datta
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.

OBJECTIVE To characterize the changes in colloid osmotic pressure during delivery and to determine the relationship between maternal and fetal colloid osmotic pressures. METHODS Clinical, prospective study. METHODS Obstetrical operating theater in a tertiary care university hospital. METHODS Thirty healthy parturient patients, at term gestation receiving spinal anesthesia for elective cesarean section. METHODS None. RESULTS Maternal colloid osmotic pressure samples were obtained at the time of intravenous insertion and delivery. Fetal umbilical vein and umbilical artery colloid osmotic pressure samples were measured from the umbilical cord at delivery. The volume of intravenous infusion and dose of ephedrine were recorded for each patient. Maternal colloid osmotic pressure at delivery was significantly less than that value measured at the time of intravenous catheter insertion in each patient (15.8 +/- 0.3 vs. 23.1 +/- 0.3 mm Hg; p < .0001). Umbilical artery colloid osmotic pressure was consistently higher than umbilical vein colloid osmotic pressure (21.0 +/- 0.4 vs. 19.4 +/- 0.3 mm Hg; p < .0001). Both umbilical artery colloid osmotic pressure and umbilical vein colloid osmotic pressure were significantly higher than maternal colloid osmotic pressure at delivery (p < .0001). The volume of intravenous infusion and the dose of ephedrine both correlated inversely with maternal colloid osmotic pressure measured at delivery (p < .05). CONCLUSIONS The reduction in maternal colloid osmotic pressure during delivery is, in part, related to intravenous fluid expansion and the amount of vasopressor administered. Despite the significant fluctuations in maternal colloid osmotic pressure, the placenta and fetus possess the capability to alter colloid osmotic pressure.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D009997 Osmotic Pressure The pressure required to prevent the passage of solvent through a semipermeable membrane that separates a pure solvent from a solution of the solvent and solute or that separates different concentrations of a solution. It is proportional to the osmolality of the solution. Osmotic Shock,Hypertonic Shock,Hypertonic Stress,Hypotonic Shock,Hypotonic Stress,Osmotic Stress,Hypertonic Shocks,Hypertonic Stresses,Hypotonic Shocks,Hypotonic Stresses,Osmotic Pressures,Osmotic Shocks,Osmotic Stresses,Pressure, Osmotic,Pressures, Osmotic,Shock, Hypertonic,Shock, Hypotonic,Shock, Osmotic,Shocks, Hypertonic,Shocks, Hypotonic,Shocks, Osmotic,Stress, Hypertonic,Stress, Hypotonic,Stress, Osmotic,Stresses, Hypertonic,Stresses, Hypotonic,Stresses, Osmotic
D010952 Plasma Substitutes Any liquid used to replace blood plasma, usually a saline solution, often with serum albumins, dextrans or other preparations. These substances do not enhance the oxygen- carrying capacity of blood, but merely replace the volume. They are also used to treat dehydration. Blood Expanders,Plasma Volume Expanders,Expanders, Blood,Expanders, Plasma Volume,Substitutes, Plasma,Volume Expanders, Plasma
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D003102 Colloids Two-phase systems in which one is uniformly dispersed in another as particles small enough so they cannot be filtered or will not settle out. The dispersing or continuous phase or medium envelops the particles of the discontinuous phase. All three states of matter can form colloids among each other. Hydrocolloids,Colloid,Hydrocolloid
D004809 Ephedrine A phenethylamine found in EPHEDRA SINICA. PSEUDOEPHEDRINE is an isomer. It is an alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used for asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. Ephedrine Hydrochloride,Ephedrine Renaudin,Ephedrine Sulfate,Erythro Isomer of Ephedrine,Sal-Phedrine,Ephedrine Erythro Isomer,Hydrochloride, Ephedrine,Renaudin, Ephedrine,Sal Phedrine,SalPhedrine,Sulfate, Ephedrine
D005260 Female Females
D005312 Fetal Blood Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery. Cord Blood,Umbilical Cord Blood,Blood, Cord,Blood, Fetal,Blood, Umbilical Cord,Bloods, Cord,Bloods, Fetal,Bloods, Umbilical Cord,Cord Blood, Umbilical,Cord Bloods,Cord Bloods, Umbilical,Fetal Bloods,Umbilical Cord Bloods

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