The fluid balance observed postnatally on normal pregnancies, pregnancies with preeclampsia, and on pregnancies with oedema and proteinuria

Abstract

in arterial blood pressure and systemic vascular resistance. Mostly, all of these changes are generally reversed in weeks or months after delivery [1][2][3][4][5] . To be more specific, pregnancy is a volume-expanding state characterized by net sodium retention of 900 to 1000 mEq, as well water retention of 1.1 to 1.6 L, mediated by a balance between natriuretic and anti-natriuretic forces 1 . A rise in serum aldosterone is ABSTRACT INTRODUCTION It is observed that delivery does not completely eliminate the risk of developing symptoms of preeclampsia, as well as its impending complications. The postpartum period is often associated with a high risk of developing preeclampsia, eclampsia and HELLP syndrome. Yet, there is neither an established standard, nor specific guidelines for peripartum fluid management. Our purpose is to study during the first four days of the postpartum period the differences in fluid balance on: normal pregnancies, pregnancies with preeclampsia and pregnancies with oedema and proteinuria. METHODS The setting was the Gaia private maternity clinic in Athens, where 100 women in the postpartum period took part in the study and were requested to fill in a data collection-sheet, specially developed for the study. They were recruited between January 2014 and November 2014 and were divided into three groups. Group I consisted of all normal pregnancies, Group II those with oedema and proteinuria, and Group III those with preeclampsia. The demographic and clinical characteristics of the women and fetuses were initially recorded. Subsequently, daily records of fluid balance, as well as body weight, were kept for four days after labor. Descriptive statistics were used to analyze the demographic data of the sampled women. We compared the fluid balances among the three groups using t-test association and one-way Anova. RESULTS The mean age of the women was 32.48±4.38 years. Out of a total of 100 women, 59 of them had a normal pregnancy (Group I), 24 developed oedema and proteinuria (Group II) and 17 developed preeclampsia (Group III). All three groups had a positive fluid balance on the first day postpartum and only the first group had a negative cumulative fluid balance from the second day postpartum and onwards. The second group despite having started to discard a small volume of fluid, from the second day postpartum, the balance remained positive throughout the next two days. The third group however, had a negative fluid balance only during the fourth day after labor. CONCLUSIONS Our results indicate a difference in the kinetics of fluids in women with preeclampsia, compared to those that had a normal pregnancy and postpartum period. Consequently, there appears to be a need for more rational management and follow up on fluid balance throughout labor. INTRODUCTIONPregnancy involves remarkable changes in the anatomy and physiology that affect the renal and the cardiovascular system, in many aspects. These changes are in fact essential for the development and maintenance of a successful pregnancy, both ...