Predicting preeclampsia course based on endothelium-dependent dilation
DOI: 10.32364/2618-8430-2021-4-4-317-321
R.Kh. Shavaeva, A.V. Murashko, V.M. Zuev, S.A. Timofeev, T.A. Dzhibladze
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow,
Russian Federation
Aim: to determine prognostic criteria of severe preeclampsia based on the assessment of endothelium-dependent (ED) flow-mediated dilation (FMD) of the brachial artery (BA).
Patients and Methods: 97 pregnant women (>28 weeks of pregnancy) with moderate preeclampsia were enrolled. These women were retrospectively divided into two groups. Group 1 included 42 pregnant women (mean age 30.0±0.5 years) in whom the severity of preeclampsia increased after treatment. Group 2 included 55 pregnant women (mean age 31.0±0.7 years) whose severity of preeclampsia did not increase after treatment. Group 3 (control group) included 20 women with a healthy pregnancy. ED FMD of BA was assessed by vascular ultrasound using a reactive hyperemia test. In addition, BA diameter and peak systolic velocity (PSV) 15 sec and 1 min after cuff deflation were measured. These measurements were performed at enrollment and after one week (or in feeling worse).
Results: healthy pregnancy was characterized by a gradual increase in BA diameter in response to cuff inflation (by 15.7% and 23.9% after 15 sec and 1 min, respectively, at baseline and by 17.8% and 21.3% after 15 sec and 1 min, respectively, after one week). In pregnant women with preeclampsia, baseline changes in BA diameter were less significant. Meanwhile, after one week, a reduction in BA diameter was reported in group 1, and close-to-normal BA diameter was reported in group 2. In group 3, BA PSV increased by 5.2% and 16% in 15 sec and 1 min, respectively, after cuff inflation. In pregnant women with preeclampsia, BA PSV, in contrast, was reduced (more significant after 1 min).
Conclusion: increased BA diameter and PSV by less than 10% 15 sec and 1 min after cuff inflation indicate endothelial dysfunction. A negative pattern of changes in these parameters suggests an unfavorable course of preeclampsia and its transition to severe disease.
Keywords: preeclampsia, e ndothelial dysfunction, vasodilation, brachial artery, peak systolic velocity, prognosis.
For citation: Shavaeva R.Kh., Murashko A.V., Zuev V.M. et al. Predicting preeclampsia course based on endothelium-dependent dilation. Russian Journal of Woman and Child Health. 2021;4(4):317–321 (in Russ.). DOI: 10.32364/2618-8430-2021-4-4-317-321.
About the authors:
Ruzanna Kh. Shavaeva — postgraduate student of the Department of Obstetrics and Gynecology No. 1 of N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0002-5953-0503.
Andrey V. Murashko — Dr. Sc. (Med.), Associate Professor, professor of the Department of Obstetrics and Gynecology No. 1 of N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0003-0663-2909.
Vladimir M. Zuev — Dr. Sc. (Med.), Professor, professor of the Department of Obstetrics and Gynecology No. 1 of N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0001-8715-2020.
Sergey A. Timofeev — assistant of the Department of Obstetrics and Gynecology No. 1 of N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0001-7380-9255.
Tea A. Dzhibladze — Dr. Sc. (Med.), Professor, professor of the Department of Obstetrics and Gynecology No. 1 of N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0003-1540-5628.
Contact information: Ruzanna Kh. Shavaeva, e-mail: ruzanna-shavaeva@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 12.08.2021.
Revised 06.09.2021.
Accepted 29.09.2021.
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