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Fluid Management in Obstetric Patients

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Body Fluid Management

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Abstract

In pregnancy, hemodynamic and cardiovascular changes occur that prevent blood loss during delivery. In fact, there is an increase in blood volume, during the first trimester [1]. The volume of blood continues to expand rapidly in the second trimester before reaching a plateau in the last trimester. At the same time, the increase in Red Blood Cell (RBC) mass occurs more slowly, leading to a relative anemia and hemodilution [2], with the latter peaking by 30–32 weeks of gestation. Dilutional anemia is therefore common, especially between 28 and 34 weeks gestation, when hemoglobin concentrations are lowest. The accretion in RBC mass results in an 18–25% increase in the first months of pregnancy, followed by a drop after childbirth due to hemorrhage [3–5]. The increase in red cell volume provides for the extra oxygen demands of the mother and fetus. The lower end of the normal range for hemoglobin in pregnancy is 11–12 g/dL. These physiological responses have considerable advantages during pregnancy: improved placental perfusion, decreased risk of thrombosis and an adequate blood supply despite the bleeding that occurs with childbirth [6–8].

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Authors and Affiliations

  1. Postgraduate School of Anesthesia and Intensive Care, Anesthesia, Intensive Care and Pain Management Department, University School of Medicine Campus Bio-Medico of Rome, Rome, Italy

    Annalaura Di Pumpo

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  1. Maria Grazia Frigo
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  2. Annalaura Di Pumpo
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  3. Felice Eugenio Agrò
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Correspondence to Annalaura Di Pumpo .

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Editors and Affiliations

  1. Intensive Care and Pain Management Department, University School of Medicine Campus Bio-Medico of Rome, Rome, Italy

    Felice Eugenio Agrò MD (Commander to the Order of Merit of the Italian Republic, Full Professor of Anesthesia and Intensive Care, Chairman of Postgraduate School of Anesthesia and Intensive Care, Director of Anesthesia) (Commander to the Order of Merit of the Italian Republic, Full Professor of Anesthesia and Intensive Care, Chairman of Postgraduate School of Anesthesia and Intensive Care, Director of Anesthesia)

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Frigo, M.G., Di Pumpo, A., Agrò, F.E. (2013). Fluid Management in Obstetric Patients. In: Agrò, F.E. (eds) Body Fluid Management. Springer, Milano. https://doi.org/10.1007/978-88-470-2661-2_15

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  • DOI: https://doi.org/10.1007/978-88-470-2661-2_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2660-5

  • Online ISBN: 978-88-470-2661-2

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