Plasma Volume Expansion No Help in Preeclampsia


RENO, NEV. — Plasma volume expansion, once thought of as a possible treatment for severe preeclampsia, appears to confer no benefit even after a 1-year follow-up, results of a randomized controlled trial suggest.

The trial, which compared plasma volume expansion with temporizing treatment, showed that there were no differences in pregnancy outcomes and no differences in mental or psychomotor scores of the children at 1 year of age, reported Wessel Ganzevoort, M.D., and colleagues of Vrije University Medical Center, Amsterdam.

The study involved 216 women with severe preeclampsia; hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome; or fetal growth restriction related to pregnancy-induced hypertension.

Gestational ages ranged between 24 and 33 weeks at the start of the study, the investigators wrote in a poster that was presented at the annual meeting of the Society for Maternal-Fetal Medicine.

Women randomized to the plasma volume expansion group received 500 mL of 6% hexaethyl starch daily. Patients in both groups received antihypertensive treatment and magnesium sulfate when appropriate, they said.

Of the 111 women in the treatment group, 89 (80%) delivered live infants. Similarly, of the 105 women in the control group, 91 (87%) delivered live infants. The difference between the two groups was not statistically significant.

At 1 year of age, children from both groups showed lower scores than would be expected in the normal population on the Bayley mental developmental index (MDI) and the Bayley psychomotor developmental index (PDI).

But a comparison between the two groups demonstrated no significant differences in the proportion of children with abnormal or suspect MDI or PDI scores.

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