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. 2000;1999(2):CD001805.
doi: 10.1002/14651858.CD001805.

Plasma volume expansion for treatment of women with pre-eclampsia

L Duley  1 , J Williams, D J Henderson-Smart
Affiliations

Plasma volume expansion for treatment of women with pre-eclampsia

L Duley et al. Cochrane Database Syst Rev. 2000.

Abstract

Background: Plasma volume is reduced amongst women with pre-eclampsia. This association has led to the suggestion that expanding the plasma volume might improve maternal and uteroplacental circulation, and so potentially improve outcome for both the woman and her baby.

Objectives: The aim of this review was to assess the effects of plasma volume expansion for the treatment of women with pre-eclampsia.

Search strategy: The register of trials maintained by the Cochrane Pregnancy and Childbirth Group, and the Cochrane Controlled Trials Register Issue 1 1999 were searched for trials meeting the selection criteria.

Selection criteria: Randomised trials were included. Quasi-random designs were excluded. Participants were women with hypertension during pregnancy, with or without proteinuria. Women who were postpartum at trial entry were excluded. Interventions were any comparison of plasma volume expansion with no expansion, or of one plasma volume expander with another.

Data collection and analysis: Data were extracted independently by two reviewers. Discrepancies were resolved by discussion. There was no blinding of authorship or results.

Main results: Three trials involving 61 women were included in this review. All compared a colloid solution with no plasma volume expansion. For every outcome reported, the confidence intervals are very wide and cross the no effect line.

Reviewer's conclusions: There is insufficient evidence for any reliable estimates of the effects of plasma volume expansion for women with pre-eclampsia.

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Conflict of interest statement

None known.

References

References to studies included in this review

South Africa 1989 {published data only}
    1. Belfort M, Uys P, Dommisse J, Davey DA. Haemodynamic changes in gestational proteinuric hypertension: the effects of rapid volume expansion and vasodilator therapy. British Journal of Obstetrics and Gynaecology 1989;96:634‐41. - PubMed
UK 1993 {published data only}
    1. Lowe SA, Hetmanski DJ, Macdonald I, Boughton Pipkin F, Rubin PC. Intravenous volume expansion therapy in pregnancy‐induced hypertension: the role of vasoactive hormones. Hypertension in Pregnancy 1993;12:139‐51.
USA 1980 {published data only}
    1. Sehgal NN, Hitt JR. Plasma volume expansion in the treatment of pre‐eclampsia. American Journal of Obstetrics and Gynecology 1980;138:165‐8. - PubMed

References to studies excluded from this review

Denmark 1984 {published data only}
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Germany 1993 {published data only}
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Netherlands 1992 {published data only}
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South Africa 1988 {published data only}
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UK 1986 {published data only}
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USA 1989 {unpublished data only}
    1. Welt SI. Acute expansion of blood volume in the pre‐eclamptic patient with prior hypertension, just prior to delivery. Personal communication.

References to studies awaiting assessment

Ganzevoort 2002 {published data only}
    1. Ganzevoort JW, Rep A, Vries JIP, Wolf H. An ongoing randomized trial on plasma volume expansion in severe and early preeclampsia [abstract]. Hypertension in Pregnancy 2002;21(Suppl 1):46.
Ganzevoort 2004 {published data only}
    1. Ganzevoort W, Rep A, Bonsel G, Vries H, Wolf H. PVE has no beneficial effect in severe hypertensive complications of pregnancy [abstract]. Hypertension in Pregnancy 2004;23(Suppl 1):15.
Ganzevoort 2004a {published data only}
    1. Ganzevoort W, Rep A, Vries H, Bonsel G, Wolf H. Dynamic aspects of preeclampsia [abstract]. American Journal of Obstetrics and Gynecology 2004;191(6 Suppl 1):S36.
Ganzevoort 2004b {published data only}
    1. Ganzevoort W, Rep A, Wassenaer AG, Kaspers AG, Vries H, Bonsel G, et al. Long‐term infant outcome of a trial of plasma volume expansion in women with preeclampsia remote from term [abstract]. American Journal of Obstetrics and Gynecology 2004;191(6 Suppl 1):S36.
Ganzevoort 2005 {published data only}
    1. Ganzevoort W, Rep A, Bonsel GJ, Vries JIP, Wolf H, PETRA investigators. A randomized trial of plasma volume expansion in hypertensive disorders of pregnancy: influence on the pulsatility indices of the fetal umbilical artery and middle cerebral artery. American Journal of Obstetrics and Gynecology 2005;192(1):233‐9. - PubMed
Ganzevoort 2005a {published data only}
    1. Ganzevoort W, Rep A, Bonsel GJ, Fetter WPF, Sonderen L, Vries JIP, et al. A randomised controlled trial comparing two temporising management strategies, one with and one without plasma volume expansion, for severe and early onset pre‐eclampsia. BJOG: an international journal of obstetrics and gynaecology 2005;112:1358‐68. - PubMed
Ganzevoort 2007 {published data only}
    1. Ganzevoort W, Rep A, Bonsel GJ, Vries JI, Wolf H, for the PETRA investigators. Dynamics and incidence patterns of maternal complications in early‐onset hypertension of pregnancy. BJOG: an international journal of obstetrics and gynaecology 2007;114(6):741‐50. - PubMed
Heilmann 2001 {published data only}
    1. Heilmann L, Gerhold S, Tempelhoff GF, Pollow K. The role of intravenous volume expansion in moderate pre‐eclampsia. Clinical Hemorheology & Microcirculation 2001;25(3‐4):83‐9. - PubMed
Metsaars 2004 {published data only}
    1. Metsaars W, Ganzevoort W, Karemakers J, Rang S, Wolf H. Effect of therapeutic plasma volume expansion on sympathetic hyperactivity in preeclampsia [abstract]. Hypertension in Pregnancy 2004, (Suppl 1):73.
Metsaars 2006 {published data only}
    1. Metsaars WP, Ganzevoort W, Karemaker JM, Rang S, Wolf H. Increased sympathetic activity present in early hypertensive pregnancy is not lowered by plasma volume expansion. Hypertension in Pregnancy 2006;25(3):143‐57. - PubMed
Rep 2003 {published data only}
    1. Rep A, Ganzevoort W, Wolf H. A randomized trial of temporizing management with or without plasma volume expansion in severe and early preeclampsia: maternal morbidity [abstract]. American Journal of Obstetrics and Gynecology 2003;189(6 Suppl 1):S60.
Rep 2004 {published data only}
    1. Rep A, Ganzevoort W, Bonsel G, Wolf H, Vries H. Temporising management with plasma volume expansion in severe and early preeclampsia [abstract]. Hypertension in Pregnancy 2004;23(Suppl 1):14.
Rep 2008 {published data only}
    1. Rep A, Ganzevoort W, Wassenaer AG, Bonsel GJ, Wolf H, Vries JI, et al. One‐year infant outcome in women with early‐onset hypertensive disorders of pregnancy. BJOG: an international journal of obstetrics and gynaecology 2008;115(2):290‐8. - PubMed
Spaanderman 2006 {published data only}
    1. Spaanderman MEA. Cardiovascular and autonomic reactivity in women with a history of pre‐eclampsia (ongoing trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006) 2006.

Additional references

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References to other published versions of this review

CDSR 2001
    1. Duley L, Williams J, Henderson‐Smart DJ. Plasma volume expansion for treatment of women with pre‐eclampsia (Cochrane Review). The Cochrane Library 2001, Issue 3. - PMC - PubMed
Duley 1995
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