Intrapartum to postpartum changes in colloid osmotic pressure

A study was undertaken to determine the effect of route of delivery on plasma colloid osmotic pressure. Plasma colloid osmotic pressure was measured on admission to the hospital and 8 to 24 hours post partum in 72 patients at term with uncomplicated prenatal histories. Thirty-six patients underwent uncomplicated vaginal deliveries (local anesthesia, 18; conduction anesthesia, 18) and 36 patients had cesarean sections (conduction anesthesia, 18; general anesthesia, 18). The mean (±SD) intrapartum colloid osmotic pressure of the overall group was 21.0 ± 2.1 mm Hg, and it declined significantly (p < 0.01) to 15.4 ± 2.1 mm Hg post partum. A comparison of the intraprtum and postpartum reductions in colloid osmotic pressure between patients who underwent vaginal delivery and those who underwent cesarean section revealed no significant differences. Furthermore, the mean reductions in colloid osmotic pressure when all four groups were compared by type of anesthesia were not significantly different. Fifteen patients (20.8%) in the study had a postpartum colloid osmotic pressure of less than 13.6 mm Hg, and five (6.9%) had a postpartum colloid osmotic pressure of less than 12.5 mm Hg. Our results indicate that, for normal pregnancy, colloid osmotic pressure is uniformly lowered in the post partum period and, some cases, to levels that have been reported to be dangerously low.