Sodium Metabolism in Normal Pregnancy and in Preeclampsia

Published on Jan 1, 1986
路 DOI :10.1007/978-1-4613-2619-9_6
Wolfram E. Nolten3
Estimated H-index: 3
,
Edward N. Ehrlich2
Estimated H-index: 2
Sources
Abstract
During the course of normal gestation, major changes in volume, distribution, and concentration of body fluids occur in the maternal organism, in order to meet the requirements of the developing conceptus. In pregnant as in nonpregnant subjects, sodium and water balance are governed by hypothalamic centers that control the release of antidiuretic hormone and influence thirst sensation, by renal adjustments of sodium and fluid excretion, and by secretion of gluco- and mineralocorticoids by the adrenal cortex. These homeostatic mechanisms in pregnant women must accommodate increasing levels of salt-retaining, natriuretic, and vasodepressor factors associated with advancing pregnancy if sodium and water balance are to be maintained.
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References59
Newest
Hypertensive disorders in pregnancy are the leading cause of maternal death in the United States and in many other parts of the world. A recent prospective study has indicated that the susceptibility to preeclampsia-eclampsia is inherited and probably is determined by a single recessive gene. However, the causes are still unknown. The incidences, prevalences, definitions, cardinal signs, and patients at increased risk for hypertensive disorders in pregnancy are discussed. Successful management o...
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Abstract In this investigation we found that little of intravenously infused [14C]deoxycorticosterone (DOC) was converted to [14C]DOC-SO4 that entered plasma. Moreover little of intravenously infused [3H]DOC-SO4 was metabolized by way of DOC except by intestinal bacterial enzymes. However evidence was obtained that plasma DOC is converted to DOC-SO4 in liver, but little of the DOC-SO4 formed in liver escapes into blood; rather the DOC-SO4 enters bile and in the intestine is converted, in part, t...
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Abstract We measured deoxycorticosterone (DOC) and progesterone (P) in plasma of 47 women pregnant with a dead fetus and sequentially throughout gestation in 35 women pregnant with a live fetus. When P levels in plasma were low, the plasma levels of DOC in women pregnant with a dead fetus varied but usually were similar to those in women pregnant with a live fetus. However, when P levels were high, the levels of DOC in some women pregnant with a dead fetus were considerably lower than those in w...
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#1W.E. Nolten (UW: University of Wisconsin-Madison)H-Index: 2
#2L. Hughey Holt (UW: University of Wisconsin-Madison)H-Index: 1
Last. P.A. Rueckert (UW: University of Wisconsin-Madison)H-Index: 2
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Abstract The source of the markedly increased secretion of desoxycorticosterone (DOC) in pregnancy has not been precisely defined. Earlier studies indicated that elevated DOC does not arise from the maternal adrenal glands. The previously observed steep gradient between fetal and maternal DOC and DOC sulfate concentrations seemed to point to a fetal source. A recent study suggests that DOC may also be derived from extra-adrenal conversion of maternal progesterone. The present investigation docum...
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The Yanomama Indians of northern Brazil and southern Venezuela have been identified as a "no-salt" culture. In this study, data were obtained to determine in this population the adjustments of sodium-related hormones to the stresses imposed upon sodium balance by pregnancy and prolonged lactation. Controls against the possibility that findings in the Yanomama were ethnic rather than dietary were provided by similar observations in the Guaymi Indians of Panama, who have free access to salt. Urina...
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#1Craig A. Winkel (UTSW: University of Texas Southwestern Medical Center)H-Index: 13
#2Leon Milewich (UTSW: University of Texas Southwestern Medical Center)H-Index: 34
Last. Paul C. MacDonaldH-Index: 80
view all 6 authors...
During the third trimester of human pregnancy the concentrations of deoxycorticosterone (DOC) in maternal plasma are 4-50 times those in nonpregnant women and men. It has been suggested that the increased amount of DOC in maternal plasma originates in the fetal compartment. We considered an alternate explanation for the high levels of DOC in plasma or near-term pregnant women, viz., that DOC may be derived in part from 21-hydroxylation of maternal plama progesterone. To test this hyposthesis we ...
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Abstract Three patients with severe pre-eclampsia-toxemia were studied with thermodilution tip pulmonary artery catheters. All patients were delivered by cesarean section with general anesthesia and endotracheal intubation. The left ventricular stroke work indices (LVSWI) of these patients were higher than those of normal nonpregnant subjects. There was no evidence of myocardial depression in terms of either cardiac index or the LVSWI-pulmonary capillary wedge pressure (Frank-Starling) relations...
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#1Thomas J. Benedetti (SC: University of Southern California)H-Index: 6
#2David B. Cotton (SC: University of Southern California)H-Index: 4
Last. Frank C. Miller (SC: University of Southern California)H-Index: 17
view all 4 authors...
Abstract Ten patients with severe pre-eclampsia were studied throughout labor and delivery and during the early puerperium with a flow-directed pulmonary artery catheter. Cardiac output was higher than previously described in normal patients. Pulmonary artery pressures were not significantly altered from the normal pregnant values. The usual increase in cardiac output occurring in the early puerperium was not observed in the patients with severe pre-eclampsia. Central venous pressure and pulmona...
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#1Norman F. GantH-Index: 8
#2R. J. WorleyH-Index: 13
Cited By2
Newest
#1Domenico RussoH-Index: 30
Last. V. E. AndreucciH-Index: 10
view all 3 authors...
Hypertension in pregnancy remains a major cause of maternal and fetal morbidity and mortality1. Hypertension may either precede pregnancy (鈥榗hronic hypertension in pregnancy鈥) or occur in a previously normotensive woman from a disorder of pregnancy itself (鈥榩regnancy-induced hypertension鈥).
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#1Andreucci VeH-Index: 3
#2Antonio Dal CantonH-Index: 3
Last. Domenico RussoH-Index: 30
view all 3 authors...
There is still controversy as to whether mild hypertension antedating pregnancy has to be treated in pregnant women. Some authors are against treatment since the possible benefit of normalizing blood pressure is not relevant to the brief span of gestation [1], Others emphasize that treatment of chronic hypertension in pregnancy (CHP) reduces the occurrence of midtrimester abortions [2].
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