L Duley1, J Williams, D J Henderson-Smart. 1. Resource Centre for Randomised Trials, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF. lelia.duley@ndm.ox.ac.uk
Abstract
BACKGROUND: Plasma volume is reduced amongst women with pre-eclampsia. This association has led to the suggestion that expanding the plasma volume might improve maternal and uteroplacental circulation, and so potentially improve outcome for both the woman and her baby. OBJECTIVES: The aim of this review was to assess the effects of plasma volume expansion for the treatment of women with pre-eclampsia. SEARCH STRATEGY: The register of trials maintained by the Cochrane Pregnancy and Childbirth Group, and the Cochrane Controlled Trials Register Issue 1 1999 were searched for trials meeting the selection criteria. SELECTION CRITERIA: Randomised trials were included. Quasi-random designs were excluded. Participants were women with hypertension during pregnancy, with or without proteinuria. Women who were postpartum at trial entry were excluded. Interventions were any comparison of plasma volume expansion with no expansion, or of one plasma volume expander with another. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. Discrepancies were resolved by discussion. There was no blinding of authorship or results. MAIN RESULTS: Three trials involving 61 women were included in this review. All compared a colloid solution with no plasma volume expansion. For every outcome reported, the confidence intervals are very wide and cross the no effect line. REVIEWER'S CONCLUSIONS: There is insufficient evidence for any reliable estimates of the effects of plasma volume expansion for women with pre-eclampsia.
BACKGROUND: Plasma volume is reduced amongst women with pre-eclampsia. This association has led to the suggestion that expanding the plasma volume might improve maternal and uteroplacental circulation, and so potentially improve outcome for both the woman and her baby. OBJECTIVES: The aim of this review was to assess the effects of plasma volume expansion for the treatment of women with pre-eclampsia. SEARCH STRATEGY: The register of trials maintained by the Cochrane Pregnancy and Childbirth Group, and the Cochrane Controlled Trials Register Issue 1 1999 were searched for trials meeting the selection criteria. SELECTION CRITERIA: Randomised trials were included. Quasi-random designs were excluded. Participants were women with hypertension during pregnancy, with or without proteinuria. Women who were postpartum at trial entry were excluded. Interventions were any comparison of plasma volume expansion with no expansion, or of one plasma volume expander with another. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. Discrepancies were resolved by discussion. There was no blinding of authorship or results. MAIN RESULTS: Three trials involving 61 women were included in this review. All compared a colloid solution with no plasma volume expansion. For every outcome reported, the confidence intervals are very wide and cross the no effect line. REVIEWER'S CONCLUSIONS: There is insufficient evidence for any reliable estimates of the effects of plasma volume expansion for women with pre-eclampsia.
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