Blood volume determination in obese and normal-weight gravidas: the hydroxyethyl starch method
Blood volume determination in obese and normal-weight gravidas: the hydroxyethyl starch method
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DOI：
10.1016/j.ajog.2015.05.021
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发表时间：
2015-09-01
影响因子：
9.8
通讯作者：
Mercer, Brian M.
中科院分区：
文献类型：
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作者：
Vricella, Laura K.;Louis, Judette M.;Mercer, Brian M.
目的：妊娠期肥胖对母体血容量的影响尚未报道。研究设计：采用改良的羟乙基淀粉（HES）稀释技术，对30名正常体重（妊娠前体重指数[BMI] < 25 kg/m2）和30名妊娠34周以上的肥胖（妊娠前BMI > 35 kg/m2）孕妇的血容量进行了评估。在羟乙基淀粉酸水解后，分析羟乙基淀粉注射前和注射后10分钟采集的血样的血糖浓度。结果：肥胖孕妇孕前和孕期BMI均高于正常孕妇，而孕期BMI高于正常孕妇（平均值[SD]）：妊娠前（41 [4] vs 22 [2] kg/m2，P=.001）;访视（42 [4] vs 27 [2] kg/m2，P = .001），但体重增加（5 [7] vs 12 [4] kg，P = .001）低于正常体重女性。肥胖孕妇的估计总血容量与正常体重妇女相似（8103 +/- 2452 vs 6944 +/- 2830 mL，P = .1），但每千克体重的血容量较低（73 +/- 22 vs 95 +/- 30 mL/kg，P = .007）。结论：肥胖孕妇的循环血容量与正常孕妇相近，但每公斤体重的血容量低于正常孕妇。
OBJECTIVE: The impact of obesity on maternal blood volume in pregnancy has not been reported. We compared the blood volumes of obese and normal-weight gravidas using a validated hydroxyethyl starch (HES) dilution technique for blood volume estimation.STUDY DESIGN: Blood volumes were estimated in 30 normal-weight (pregravid body mass index [BMI] < 25 kg/m(2)) and 30 obese (pregravid BMI > 35 kg/m(2)) gravidas > 34 weeks' gestation using a modified HES dilution technique. Blood samples obtained before and 10 minutes after HES injection were analyzed for plasma glucose concentrations after acid hydrolysis of HES. Blood volume was calculated from the difference between glucose concentrations measured in hydrolyzed plasma.RESULTS: Obese gravidas had higher pregravid and visit BMI (mean [SD]): pregravid (41 [4] vs 22 [2] kg/m(2), P=.001); visit (42 [4] vs 27 [2] kg/m(2), P = .001), but lower weight gain (5 [7] vs 12 [4] kg, P = .001) than normal-weight women. Obese gravidas had similar estimated total blood volume to normal-weight women (8103 +/- 2452 vs 6944 +/- 2830 mL, P = .1), but lower blood volume per kilogram weight (73 +/- 22 vs 95 +/- 30 mL/kg, P = .007).CONCLUSION: Obese gravidas have similar circulating blood volume, but lower blood volume per kilogram body weight, than normal-weight gravidas near term.