Water immersion in preeclampsia

• Published in: American journal of obstetrics and gynecology 2006-12, Vol.195 (6), p.1590-1595
• Main Authors: Elvan-Taşpınar, Ayten, Franx, Arie, Delprat, Constance C., Bruinse, Hein W., Koomans, Hein A.
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Blood Pressure; Cardiac Output; Diastole; Diseases of mother, fetus and pregnancy; Endothelium, Vascular - physiopathology; Female; Forearm - blood supply; Gynecology. Andrology. Obstetrics; Heart Rate; Humans; Immersion; Medical sciences; Pre-Eclampsia - physiopathology; Pre-Eclampsia - therapy; Preeclampsia; Pregnancy; Pregnancy. Fetus. Placenta; Regional Blood Flow; Time Factors; Vascular Resistance; Vasodilation; Water; Water immersion
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2006.05.007

Preeclampsia is associated with profound vasoconstriction in most organ systems and reduced plasma volume. Because water immersion produces a marked central redistribution of blood volume and suppresses the renin-angiotensin system response and sympathetic activity, we hypothesized that water immersion might be useful in the treatment of preeclampsia. The effects of thermoneutral water immersion for 3 hours on central and peripheral hemodynamics were evaluated in 7 preeclamptic patients, 7 normal pregnant control patients, and 7 nonpregnant women. Finger plethysmography was used to determine hemodynamic measurements (cardiac output and total peripheral resistance), and forearm blood flow was measured by strain gauge plethysmography. Postischemic hyperemia was used to determine endothelium-dependent vasodilation. Analysis was by analysis of variance for repeated measurements. During water immersion cardiac output increased while diastolic blood pressure and heart rate decreased, although systolic blood pressure remained unchanged in each group. Forearm blood flow increased significantly in the normal pregnant and preeclamptic subjects. Total peripheral resistance decreased in all groups, but values in preeclamptic patients remained above those of normotensive pregnant women. Water immersion had no effect on endothelium-dependent vasodilation in the preeclamptic group, and most hemodynamic changes that were observed reversed to baseline within 2 hours of completion of the procedure. Although water immersion results in hemodynamic alterations in a manner that is theoretically therapeutic for women with preeclampsia, the effect was limited and short-lived. In addition water immersion had no effect on endothelium-dependent vasodilation in women with preeclampsia. The therapeutic potential for water immersion in preeclampsia appears to be limited.