Comparative Study of Endothelial Function and Uterine Artery Doppler Velocimetry between Pregnant Women with or without Preeclampsia Development

Brandão, Augusto Henriques Fulgêncio; Pereira, Ludmila Maria Guimarães; Gonçalves, Alessandra Cristina de Oliveira; Reis, Zilma Silveira Nogueira; Leite, Henrique Vítor; Cabral, Antônio Carlos Vieira

doi:10.1155/2012/909315

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…In 2003, Takase et al, applying FMD in a group of pregnant women at the end of the second gestational trimester, found sensitivity values close to 90%; however, those authors did not differentiate between the two clinical presentations of PE (late and early) ( 17 ) . Other studies have demonstrated that the FMD values are significantly reduced at the end of the second trimester in pregnant women who later develop either late or early PE ( 18 , 19 ) . The association of FMD with Doppler flowmetry of uterine arteries also presented good results in the prediction of PE ( 20 ) .…”

Section: Discussionmentioning

confidence: 96%

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

et al. 2014

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ObjectiveTo assess the accuracy in the prediction of both early and late preeclampsia by flow-mediated dilation of the brachial artery (FMD), a biophysical marker for endothelial dysfunction.Materials and MethodsA total of 91 patients, considered at high risk for development of preeclampsia were submitted to brachial artery FMD between 24 and 28 weeks of gestation.ResultsNineteen out of the selected patients developed preeclampsia, 8 in its early form and 11 in the late form. With a cut-off value of 6.5%, the FMD sensitivity for early preeclampsia prediction was 75.0%, with specificity of 73.3%, positive predictive value (PPV) of 32.4% and negative predictive value (NPV) of 91.9%. For the prediction of late preeclampsia, sensitivity = 83.3%, specificity = 73.2%, PPV = 34.4% and NPV = 96.2% were observed. And for the prediction of all associated forms of preeclampsia, sensitivity = 84.2%, specificity = 73.6%, PPV = 45.7% and NPV = 94.6% were observed.ConclusionFMD of the brachial artery is a test with good accuracy in the prediction of both early and late preeclampsia, which may represent a positive impact on the follow-up of pregnant women at high risk for developing this syndrome.

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Section: Discussionmentioning

confidence: 96%

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

et al. 2014

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“…This observation was supported by the Brandao AHF et al . (2012)[ 4 ] study, in which FMD was performed twice for a patient, first at 16–20 weeks and second at 24–28 weeks of gestational age. They found that the group of patients who did not develop preeclampsia had shown an increase in FMD (74.2 ± 184.2%) value, while the group of patients who developed preeclampsia had shown a decrease (16.6 ± 38.2%) in the value of FMD ( P = 0.003).…”

Section: Discussionmentioning

confidence: 99%

Comparison of flow-mediated dilation (FMD) of the brachial artery in normotensive versus preeclamptic pregnant females

Verma,

Mueed,

Singh

et al. 2024

Journal of Family Medicine and Primary Care

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Introduction: Flow-mediated dilation (FMD) of the brachial artery is an ultrasonography test that assesses the endothelial response to reactive hyperemia. The aim of this study was to assess the changes in FMD in preeclamptic pregnant patients and compare them with normotensive pregnant females. Methods: An analytical cross-sectional comparative study was conducted in the Department of Obstetrics and Gynaecology at King George’s Medical University (KGMU) after obtaining ethical approval. A total of 110 normotensive and 100 preeclamptic patients were recruited for the study. Using a Toshiba Ultrasound Machine with a 7–12 MHz probe, the baseline diameter of the brachial artery D1 was measured. Afterward, the cuff of the sphygmomanometer was placed distally on the forearm and it was inflated up to ≥250 mm of Hg pressure and later slowly deflated. At 90th seconds after cuff deflation, the mean of three measurements of vessel caliber (D2) was obtained. The FMD% was obtained by the following equation: FMD (%) = [(D2 − D1)/D1] ×100, where D1 = basal diameter and D2 = post-occlusion diameter. All patients were followed till delivery for maternofetal outcome. Results: FMD% was significantly lower in the preeclampsia group, and it went on decreasing with increasing severity of preeclampsia. At the cutoff of 9.4 for FMD%, its sensitivity for the prediction of preeclampsia was 65.3%, specificity was 89.3%, positive predictive value (PPV) was 94%, and negative predictive value (NPV) was 50%. Discussion: FMD is a noninvasive test, and it gets decreased before clinical signs of preeclampsia, so it can be used as a predictor of preeclampsia.

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“…As regards FMD, its utilization alone late in the second gestational trimester could identify approximately 90% of cases of PE, in a study developed by Takase et al (17) . The FMD results are significantly poorer in patients with late development of PE as from the 24th gestational week (18,19) . The association between the indirect evaluation of the endothelial function by FMD and of the placental perfusion by Doppler flowmetry of uterine arteries has proved to be highly accurate in the prediction of PE.…”

Section: Discussionmentioning

confidence: 99%

Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery

et al. 2014

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Predição de pré-eclâmpsia por meio da dopplerfluxometria das artérias uterinas e da dilatação fluxo-mediada da artéria braquial Calixto AC, Brandão AHF, Toledo LL, Leite HV, Cabral ACV. Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery. Radiol Bras. 2014 Jan/Fev;47(1):14-17. Abstract ResumoObjective: To evaluate the association of Doppler of uterine artery and flow-mediated dilation of brachial artery (FMD) in the assessment of placental perfusion and endothelial function to predict preeclampsia. Materials and Methods: A total of 91 patients considered as at risk for developing preeclampsia were recruited at the prenatal unit of the authors' institution. All the patients underwent FMD and Doppler of uterine arteries between their 24th and 28th gestational weeks. Calculations of sensitivity and specificity for both isolated and associated methods were performed. Results: Nineteen out of the 91 patients developed preeclampsia, while the rest remained normotensive. Doppler flowmetry of uterine arteries with presence of bilateral protodiastolic notch had sensitivity of 63.1% and specificity of 87.5% for the prediction of preeclampsia. Considering a cutoff value of 6.5%, FMD showed sensitivity of 84.2% and specificity of 73.6%. In a parallel analysis, as the two methods were associated, sensitivity was 94.2% and specificity, 64.4%. Conclusion: The association of Doppler study of uterine arteries and FMD has proved to be an interesting clinical strategy for the prediction of preeclampsia, which may represent a positive impact on prenatal care of patients considered as at high-risk for developing such a condition.

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Comparative Study of Endothelial Function and Uterine Artery Doppler Velocimetry between Pregnant Women with or without Preeclampsia Development

Cited by 10 publications

References 25 publications

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

Predição de pré-eclâmpsia em suas formas tardia e precoce pela dilatação fluxo-mediada da artéria braquial

Comparison of flow-mediated dilation (FMD) of the brachial artery in normotensive versus preeclamptic pregnant females

Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery

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