Oncotic therapy in management of preeclampsia

We undertook this study to examine the effects of oncotic therapy for preeclampsia (PE).

The study included 29 pregnant women with PE and 14 pregnant women with PE and intrauterine growth retardation (IUGR) and hematocrit (Htc) concentration >0.38. All study women received regular antihypertensive therapy and oncotic therapy (dextran 40 or hydroxyethyl starch). The parameters of Htc, uric acid, fibrinogen and platelet count, sonography RI (resistance index) of uterine artery, umbilical artery, middle cerebral artery and fetal biophysical profile were monitored before and after oncotic therapy. Perinatal outcome assessment was based on 5-min Apgar score, umbilical pH, need of neonatal intensive care unit (NICU) treatment, and birth weight.

Statistically significant improvement of hemorheological parameters upon the introduction of oncotic therapy was recorded in the values of Htc, fibrinogen and diastolic blood pressure, whereas other parameters (uric acid, platelet count, uterine arterial RI on the side of placentation, and systolic blood pressure) showed a decrease that did not reach statistical significance. Upon the introduction of oncotic therapy, favorable changes in perinatal Doppler ultrasonography parameters were recorded in uterine arterial RI but not in middle cerebral artery RI. There was no statistically significant change in the fetal biophysical profile (FBP) values either. Perinatal outcome was favorable with a mean 5-min Apgar score 8 and pH 7.26. Lower birth weight values (mean 2631 +/- 407 g) were consequential to preterm delivery and IUGR, resulting in a number of neonates requiring NICU treatment.

Careful oncotic treatment with antihypertensive therapy improves the maternal hemorheological parameters and uteroplacental sonographic parameters.