Hemodynamic observations in evacuation of molar pregnancy.

The high incidence of pulmonary complications following evacuation of molar gestation at 16 weeks' size of greater (27%) prompted us to institute hemodynamic monitoring in seven of these patients in an effort to determine etiologies and possible modes of therapy for this potentially life-threatening complication. Our data indicate that following suction curettage with general anesthesia there appears to be impairment of ventricular performance of a transient nature as manifested by increases in central venous pressure, mean pulmonary artery pressure, and pulmonary capillary wedge pressure, despite a slight elevation in cardiac index and a decrease in systemic vascular resistance. The possible role of general anesthesia in the development of these changes, as well as the role of the colloid osmotic pressure to wedge gradient in the development of pulmonary complications, is discussed.