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Difference of endothelial function during pregnancies as a method to predict preeclampsia

Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Systemic endothelial dysfunction has been identified as one of the main events in preeclampsia (PE). A nonhealthy vascular endothelium can be pointed out as the pathophysiological explanation of the clinical manifestations and complications of PE. Once normal pregnancy is characterized by a constant increase in endothelial function, a follow-up of this physiological event could be used as an early marker or a prediction tool to predict PE.

Objectives

To perform a longitudinal assessment of endothelial function, using an ultrasound study of brachial artery flow Flow-mediated dilation (FMD), in normotensive and preeclamptic pregnancies, to evaluate the difference of FMD values along the second trimester of pregnancy to predict PE.

Patients and methods

In a prospective cohort study, 91 pregnant women with a high risk of developing PE were subjected to FMD of the brachial artery. The difference in the FMD values, between 16+0 and 19+6 and 24+0 and 27+6 weeks of gestation were compared, taking PE development into consideration. Receiver operator characteristics (ROC) curves were created to determine the sensibility and specificity of FMD difference to predict PE.

Results

A total of 19 patients developed PE and the other 72 women remained normotensive until 1 week after delivery. When considering a cut off of +2.50 %, FMD difference, between the two evaluations, sensitivity for PE prediction was 87.5 % for early onset PE and 95.5 % for late PE.

Conclusion

The difference of FMD values between the second trimester of pregnancy can be used for PE prediction for both, early and late forms of PE.

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Acknowledgments

This study was funded by Fundação de Amparo à Pesquisa de Minas Gerais.

Conflict of interest

No potential conflict of interest relevant to this article was reported.

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Correspondence to Augusto Henriques Fulgêncio Brandão.

Additional information

Study Association This article is part of the thesis of doctoral submitted by Augusto Henrique Fulgêncio Brandão, from Faculdade de Medicina da Universidade Federal de Minas Gerais.

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Brandão, A.H.F., Félix, L.R., do Carmo Patrício, E. et al. Difference of endothelial function during pregnancies as a method to predict preeclampsia. Arch Gynecol Obstet 290, 471–477 (2014). https://doi.org/10.1007/s00404-014-3243-3

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  • DOI: https://doi.org/10.1007/s00404-014-3243-3

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