Decreased or Increased Cardiac Output in Preeclampsia? -

My groupmates and I have been debating for a while now the pathophysiology of preeclampsia in of course, women. It is quite troublesome because some of their research show that hypovolemia and decreased cardiac output accompanies preeclampsia while my own research show that hypervolemia causes edema while at the same time increases extracellular fluid increasing stroke volume thus increasing cardiac output and then leads to hypertension. What do you guys think is right?

Resarch indicates that you may both be right - WedMD notes, quot;Changes in virtually all organ systems occur in preeclampsia-eclampsia. Intense vasospasm occurs probably in response to the higher sensitivity to all endogenous pressors, particularly angiotensin II. The hypervolemia seen in normal pregnancy does not occur. Decreased intravascular volume and hemoconcentration occur at least in part because of endothelial cell damage that promotes leakage of fluid and protein from the intravascular to the interstitial space. The leakage causes contraction of the intravascular space and expansion of the interstitial space (ie, edema).quot; (1) However, it has been noted that hypovolemia exists in patients with preeclampsia with the exception of women with pyelonephritis. (2) Also quot;... It is notable that women with occult or undiagnosed renal disease may present with apparently new-onset hypertension and proteinuria in pregnancy that may mimic preeclampsia. Obtaining a careful history, physical examination, and laboratory evaluation may clarify the diagnosis.quot; (1) So, while the traditional view is that hypovolemia presents in patients with preeclamsia, there may be other pre-conditions in your patients which resulted in the hypervolemia. With the human body, the diagnosis is never cut and dried.... Good luck with your debates. Check out the research at medline, nih.org. hypertension.com, etc - there are some interesting studies regarding cardiac output and preeclampsia. Note: I am a librarian and former Navy medical staff - the opinions expressed here are my own and do not constitute medical advice.

I think it increases cardiac output, because it s caused by hypertention. The blood volume increases during pregnancy, but the only thing gained was plasma, not on erthrocytes. Could that be the reason why your groupmate think it s a decrease in cardiac output? --------------------------------------... Correction: I m sorry, I just looked up in the text book, your groupmates were correct, Preeclampsia leads to fluid volume deficit, related to fluid shifting from intravascular to extravascular space. Which means it s decrease cardiac output, because the fluid drained out from the vascular system into the tissue. So it doesn t count as Increased Cardiac output. Also, I ll give you the defination of Decreased Cardiac Output: Inadequate blood pumped by the heart to meet the metabolic demands of the body. It s just like I suspected, although the volume increased, the erthrocytes number didn t, so a preeclampic women is actually anemic, since her cardiac output is unable to meet the needs of the body s tissue.