Hemodynamic, adjusted treatment of hypertension in pregnancy. - Part I: Infusionary osmo-oncotherapy.

In hypertension pregnancy a hypoperfusion syndrome of the peripheral tissues, caused by disturbances of the microcirculation, first of all endangers the fetus in utero. The aim of treatment is to correct the hypertension in such a way that perfusion of the uteroplacental unit, as one important part of the total peripheral resistance, increases. We investigated the cardiovascular effects of intravenous infusions of 10% mannitol, 40% sorbitol, 10% low molecular dextran, 10% low molecular dextran with an admixture of 10% mannitol, as well as of the successive application of 40% sorbitol and 10% low molecular dextran in hypertensive late pregnant patients. The specific effects of osmotherapy, oncotherapy, and osmo-oncotherapy are described in detail. In severe cases requiring acute treatment, the osmo-oncotherapy is the most advantageous because it combines raising cardiac output, decreasing total peripheral resistance, and edema-mobilizing and diuresis-inducing effects.