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Difference of endothelial function during pregnancies as a method to predict preeclampsia
Augusto Henriques Fulgêncio Brandão1, Lara Rodrigues Félix, Evilane do Carmo Patrício
1Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Av. Professor Alfredo Balena 110-4° andar, Belo Horizonte, MG, Brazil, augustohfbrandao@hotmail.com.
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.
