[Indications of albumin for vascular loading during pregnancy]

Albumin infusion is used during pregnancy for volume loading in preeclampsia and/or intra-uterine growth retardation, before regional anaesthesia for Caesarean section, compensation of blood loss during haemorrhages of parturition, as well as prevention and treatment of ovarian hyperstimulation syndrome after in vitro fertilization. In preeclampsia, albumin is used for volume loading before initiating antihypertensive therapy. However it neither decreases blood pressure, nor increases uterine blood flow. Before regional anaesthesia for Caesarean section, an infusion of albumin 5% at a rate of 15 mL.kg-1 prevents hypotension in mothers (P < 0.05 versus Ringer lactate) and provides better Apgar scores in neonates (P < 0.05). Albumin is used to treat hypovolaemia in severe ovarian hyperstimulation syndrome. Recent studies have shown that in patients at high risk of ovarian hyperstimulation syndrome, 500 mL albumin 5% administered after ovocytes retrieval diminished the incidence of this syndrome (P < 0.05 versus normal saline).