[Clinical results after hemodilution with hydroxyethyl starch in pregnancy]

Abstract

Plasma volume contraction in pregnancy is diagnosed by an increase of hematocrit above 38%. Hydroxyethylstarch was administered to 30 patients with hemoconcentration alone, to 36 patients with fetal growth weight retardation and to two patients with pre-eclampsia. In the present study the tolerance and effectiveness of middle molecular hydroxyethylstarch as volume replacement was studied. The data presented a significant decrease in the incidence of small for date babies (from 52% to 34%). In addition to these findings, hematocrit, erythrocyte aggregation and plasma viscosity were decreased and cardiac output was increased. By twenty three women we registered a newborn weight below the 10th percentile according to Hohenauer. The impaired rheological properties of blood in this group were associated with a decrease of cardiac output. We conclude that hydroxyethylstarch is a safe (no maternal-fetal transfer and only a small incidence of starch storage (1.4% of patients) in the placenta) and effective colloid substance for plasma volume expansion in pregnancy.