Venous reserve capacity & autonomic function in formerly preeclamptic women.

Formerly preeclamptic women with pre-pregnant low plasma volume have a three-fold higher chance to develop recurrent gestational hypertensive disease than women with normal plasma volume. Previous studies have suggested that those women with low plasma volume have relatively low venous capacitance and high resting sympathetic tone, but exhibit no compensatory neuro-humoral regulatory changes. These changes may reflect either small size or altered function of the venous compartment, and/or impaired autonomic regulation. The aim of this thesis was to improve our understanding of the regulation of the venous and autonomic system in formerly preeclamptic women with low plasma volume as compared to those with normal plasma volume. Our results indicate that formerly preeclamptic women with low plasma volume have a reduced venous reserve capacity and impaired autonomic regulation. raining induced an increase in plasma volume and global and calf venous compliance and a reduction in resting heart rate. This suggests that training improves venous function through a reduction in sympathetic activity. Provided that these observations are confirmed in a larger study, exercise training could well be one of the better methods to improve maternal venous function prior to pregnancy and thereby pregnancy outcome. We speculate that the reduced venous reserve capacity will prevent normal plasma volume expansion in early pregnancy, and that the compensatory sympathetic dominance results in endothelial dysfunction and eventually in (recurrent) gestational hypertensive diseas