Respiratory function in severe gestational proteinuric hypertension: the effects of rapid volume expansion and subsequent vasodilatation with verapamil

Article Abstract:

Severe gestational proteinuric hypertension (GPH) is a condition of pregnancy in which women develop low cardiac output, high systemic vascular resistance, and reduced plasma volume. This can lead to a reduction in the amount of available oxygen, causing tissue damage. It is possible that increasing the plasma volume by rapidly infusing a high-molecular-weight colloidal solution (dextran-70) would have therapeutic benefit. This was tested in six women with severe GPH who were more than 28 weeks pregnant. The diagnosis of GPH was made if the patient had a consistently elevated diastolic blood pressure (over 110 mm Hg) and excess protein in the urine. Dextran-70 (average volume, 400 milliliters) was infused over a 20 to 30 minute period via a catheter placed under X-ray guidance in the pulmonary artery. Data concerning patients' physiological function, with emphasis on respiration, was obtained throughout the procedure. Results showed that most of the patients had signs of reduced oxygen availability/delivery and consumption at baseline, presenting a picture typical of severe tissue deprivation of oxygen (ischemia). After infusion of dextran-70, the variables suggesting ischemia became normal, allowing the infusion of a drug (verapamil) to produce vasodilatation. Vasodilatation to improve blood pressure that is not preceded by better oxygen delivery to tissues can have disastrous metabolic consequences. The results indicate that controlled volume expansion is beneficial for managing severe GPH. Changes in relevant physiological parameters are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Measurement, Drug therapy, Hypertension in pregnancy, Gestational hypertension, Respiratory insufficiency, Proteinuria, Verapamil

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Transvaginal ultrasonography of pelvic masses: evaluation of B-mode technique and Doppler ultrasonography

Article Abstract:

Doppler ultrasonography does not appear to be a useful adjunct procedure to help distinguish malignant from benign ovarian masses. Some physicians believe that Doppler ultrasonography, which evaluates blood flow to and within organs, might help avoid exploratory surgery. Researchers evaluated ultrasound imaging and Doppler studies on 310 women with pelvic masses of whom 51 were eventually diagnosed as having ovarian cancer. Blood flow to cancers and benign masses tended to differ, but not enough to reliably distinguish between the two.

Diagnosis, Ovarian cancer, Ovarian tumors

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A comparison of hemodynamic data derived by pulmonary artery flotation catheter and the esophageal Doppler monitor in preeclampsia

Article Abstract:

The esophageal Doppler monitor appears to underestimate the amount of blood pumped by the heart. This monitor is relatively non-invasive and was thought to be a useful alternative to pulmonary artery flotation catheter in pregnant women with pre-eclampsia.

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