PP073. The diagnostics potential of integral rheography during the dynamic examination of body fluid sectors at puerperal women with preeclampsia.

OBJECTIVES

correction of infusion intravenous therapy to avoid body hyperhydration during the infusion therapy by estimating body's water sectors condition at puerperal women with preeclampsia, which were delivered by caesarian section and received infusion intravenous therapy.

MATERIAL AND

METHODS

220 women with average and severe preeclampsia were analyzed. Due to the infusion therapy composition women were divided into 2 groups: 1- the basic group (n=110) in which the infusion solution was new hydroxyethylstarch solution (Tetraspan), which consist of starch at isooncotic solution, which electrolyte structure is similar to blood plasma and contains Na, K, Cl, Mg, Ca ions, also malats and lactats. At the 2-nd (n=110), the comparison group, we applied the standart hydrocyethylstarch solutions, starch in physiologic saline. So during the application of Tetraspan, our attention was focused on its isoionic structure, that excludes negative influence on kidneys and is the unique balanced solution for hypovolemia elimination. The third group of puerperal women - control group (n=100) includes puerperal women without preeclampsia, after Cesarean section due to other indications. The infusion therapy in this group did not include hydroxyethylstarch solution. Water sectors were investigated by integral dual frequency impedometry, method which integrated two-frequency impedometry defining volumes of liquid sectors of an organism (the general, extracellular - intravascular and intersitial, endocellular) and equilibration of liquids between sectors in time dynamic with <<Diamant - Ð>> rheography apparatus. Body liquid sectors were examined at first day and fifth day after C-section.

RESULTS

At first day after delivery in the basic group (n=110): the evident increase of the extracellular liquid's volume revealed at 59 women (53.6%), tempered increase of the extracellular liquid at 43 women (39%) and normal values of fluid sectors conditions were observed at 8 women (7.3%). In second group (n=110): at 57 (51.8%) the evident increase of the extracellular liquid's volume was revealed; at 46 (41.8%) - tempered increase and normal results were observed in 7 (6.4%) puerperal women. In control group (n=100) it was not marked the significant changes in water sectors. On 5 days in first group (n=110) it was revealed: evident at 12 (10.9%), tempered increases at 51 (46.3%), normal indicators at 47 (42.7%). In comparison group (n=110): the evident increase of extracellular liquid was revealed in 20 (18%), tempered in 59 (53.6%), normal at 31 (28%) women. At control group (n=100) the delivered results mainly shows practically up to normal values of body liquid's sector was defined.

CONCLUSION

The results analysis shows that at heavy preeclampsia the body liquids sectors normalization occurs gradually from evident to temper and then becomes normal and this adaptation depends of the infusion therapy composition. As it comes from the basic group, where at fifth day the amount of patients with temper and normal values of extracellular water appreciably increased, in comparison with the 2nd group where the normalization of liquid's sectors occurs but the process is more torpid, not as exponential as the 1st group results shows. The normalization of body hyper hydration in 1st group where Tetraspan was applied is going more optimal that is probably connected with optimal correction of hypovolemy up to the balanced structure and the improved bioavailability of Tetraspan. The growth of women with temper hyper hydration amount at 5th day in first and in second groups, occur due to the infusion therapy and liquidation of the evident hyper hydration. As the research shows the technique for diagnosis of body liquid sectors, being noninvasive and accessible, is either informative, gives the opportunity to supervise the quantity and efficiency of the infusion therapy.