Plasma Volume and Glomerular Filtration Rate in Pregnancy and Their Relation to Differences in Fetal Growth

Abstract

Summary Plasma volume and glomerular filtration rate were measured serially during pregnancy and again three months after delivery in nine healthy multigravidae with normal past obstetric histories, and in eleven multigravidae who had a history of reproductive failure (“poor reproducers”). The increase of plasma volume was less in the “poor reproducers” than in the normal women, largely but not entirely associated with babies of lower birthweight. As a reflection of the association there was a marked negative correlation between the birthweight of the baby and the lowest haemoglobin concentration reached by the mother. The rise in glomerular filtration rate was also less in the “poor reproducers” than in the normal women and in pregnancies where the baby was small the rate tended to fall from its peak value during the second half of pregnancy.

The mechanism of the increase in glomerular filtration rate in the twelve‐day pregnant rat.

“…Also, since mean red cell volume fails to change with induction of anaesthesia (and extensive surgery), the value of arterial haematocrit reflects the plasma volume of the conscious animal (Ichikawa et al 1978). Thus the reduction in haematocrit, together with the relative constancy of mean red cell volume in the 12-day pregnant rat, may be taken to indicate an increase in plasma volume, a finding in accord with studies in the pregnant human (Hytten & Leitch, 1971;Gibson, 1973). Despite the significant increase in r.p.f.…”

“…occur at an early stage and appear to be maintained throughout most of the period of gestation (Hytten & Leitch, 1971;Gibson, 1973;Davison & Hytten, 1974;Lindheimer & Katz, 1977). Studies in the rat have yielded variable results (Mathews & Taylor, 1960;Lichton, 1963;Lindheimer & Katz, 1971), although recent observations have indicated that g.f.r.…”

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

“…Vargas (2007) 40 Whittaker (1996) 38 Whittaker (1993) 37 Abudu (1988) 30 Abudu (1985) 14 Rajalakshmi (1985) 32 Bruinse (1985) 44 Hunyor (1982) 46 Pirani (1973) 7 Pirani (1973) 7 Blanche Butler (1968) 34 Hytten (1963) 5 Paintin (1962) 27 Berlin (1953) 39 Whittaker (1996) 38 Whittaker (1993) 37 Bruinse (1985) 44 Rajalakshmi (1985) 32 Abudu (1985) 14 Gibson (1973) 47 Pirani (1973) 7 Blekta (1970) 35 Blanche Butler (1968) 34 Rovinsky (1965) 51 Hytten (1963) 5 Hytten (1963) 5 Berlin (1953) 39 Berlin (1953) Only first author of each study is given. Some studies appear more than once within a gestational-age interval because they provided data for different gestational weeks within that interval.…”

Insulin-like growth factor-II regulates maternal hemodynamic adaptation to pregnancy in rats

“…Data from human volunteers show a correlation between body weight and PV, both in the nonpregnant (4) and pregnant state (19). Here, we explored the effect of maternal body weight in a dietary experiment of enhanced pregestational weight gain.…”

“…The ensuing increase in cardiac output is required to sustain the high uteroplacental perfusion demand of the fetus. The interaction between PV expansion and fetal growth is shown by the following observations: PV at 30 wk gestational age (GA), and the gestational PV increment is correlated with birth weight (19); both PV expansion and birth weight are higher in second than in first pregnancies (6); PV is subnormal from the second trimester onward in pregnancies complicated by fetal growth restriction (30); PV is increased in overweight women (4) whose babies have a higher birth weight (18). Of note, PV expansion occurs gradually and continues up to 37 wk GA (30), mirroring the fetoplacental growth pattern (3).…”