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Minerva Ginecologica 2015 Agosto;67(4):307-13

lingua: Inglese

Flow-mediated dilation of brachial artery and endothelial dysfunction in pregnant women with preeclampsia: a case control study

Oliveira O. P. 1, Araujo Júnior E. 2, Lima W. O. 1, Salustiano E. M. 3, Ruano R. 4, Martins W. P. 5, Da Silva Costa F. 6

1 Department of Epidemiology, State University of Ceará (UECE), Fortaleza‑CE, Brazil;
2 Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM‑UNIFESP), São Paulo‑SP, Brazil;
3 INRS‑ Institut Armand‑Frappier and BioMed Research Center, Université du Québéc, Laval, QC, Canada;
4 Department of Gynecology and Obstetrics, Baylor College of Medicine, and Children’s Hospital, Houston, TX, USA;
5 Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo (DGO‑FMRP‑USP), Ribeirão Preto‑SP, Brazil;
6 Department of Perinatal Medicine, Royal Women’s Hospital, and Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Victoria, Australia


AIM: Aim of the present study was to evaluate the association between endothelial dysfunction, evaluated through flow-mediated dilation (FMD) of the brachial artery, and preeclampsia.
METHODS: A case-control prospective cross-sectional study was conducted on 81 pregnant women of between 20 and 39 weeks and 5 days, among whom 40 had preeclampsia and 41 were controls. The right brachial artery was identified using color Doppler, between 2 and 5 cm above the cubital fold. The diameter of the brachial artery was measured by calculating the distance between the proximal and distal intima (D1) during diastoles. Ischemia was caused for five minutes and the artery measurement was repeated 60 seconds after ending the compression (D2), during diastoles. The FMD (%) was calculated through the equation: (D2-D1)/D1×100. The association between independent variables and the presence of preeclampsia was estimated through odds ratios (OR) and their 95% confidence intervals (95% CI).
RESULTS: Seventy-five percent of the pregnant women with preeclampsia and 26.8% of the normotensive women presented reduction in the diameter of the brachial artery (OR=8.18; 95% CI: 2.74-25.04) (P=0.000). A greater proportion of the pregnant women with pre-eclampsia (42.1% vs. 14.3%) had a history of a mother with hypertension during pregnancy (OR=4.36; 95% CI: 0.89-23.51) (P=0.045).
CONCLUSION: We identified an association between endothelial dysfunction, evaluated through FMD of the brachial artery, and preeclampsia.

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