title: Water immersion in preeclampsia.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Perinatology and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. A.Elvan-Taspinar@azu.nl
authors.forename: Ayten
authors.initials: A
authors.lastname: Elvan-Taşpinar
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
authors.forename: Constance C
authors.initials: CC
authors.lastname: Delprat
authors.forename: Hein W
authors.initials: HW
authors.lastname: Bruinse
authors.forename: Hein A
authors.initials: HA
authors.lastname: Koomans
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure; D002302:Cardiac Output; D003971:Diastole; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000098:blood supply; D006339:Heart Rate; D006801:Humans; D007101:Immersion; D011225:Pre-Eclampsia / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D012039:Regional Blood Flow; D013997:Time Factors; D014655:Vascular Resistance; D014664:Vasodilation; D014867:Water
chemical_list: D014867:Water