Plasma Volume Expansion Therapy Should be Widely used with Pregnancy Complications

Abstract

To the Editor

Professor Gallery's editorial on plasma volume therapy (1) is confining! Several abstracts presented at the 1992 Buenos Aires Hypertension in Pregnancy meeting described plasma volume expansion in conjunction with antihypertensive therapy (Hypertension in Pregnancy 1993; 12). Her paper did not discuss venous tone, which Guy ton regarded as the determining factor in hypertension. The venous side contains most of the blood volume and its tone is usually increased in hypertension (2). By combining furosomide with plasma volume expansion, the incidence of pulmonary edema can be minimized with improved hypotensive response. [In addition to being a diuretic, furosomide decreases venous tone (3).] Bed rest in pregnant women is often plasma volume therapy with mobilization of their extra vascular fluid as shown by their subsequent drop in hematocrit (4). Head-out immersion accomplishes the same thing (5). Colloid pressure usually decreases in the postpartum period because of the mobilization of extravascular fluid, as indicated by a concomitant decrease in hematocrit (6).