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
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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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 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...
#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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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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