Priyanka Garg1, Ashok Kumar Jaryal2, Garima Kachhawa3, Alka Kriplani4, Kishore Kumar Deepak2. 1. Department of Physiology, Government Allopathic Medical College, Banda, Uttar Pradesh, India. 2. Department of Physiology, All India Institute of Medical Sciences, New Delhi, India. 3. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: garimakachhawa2012@gmail.com. 4. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Abstract
OBJECTIVE: To evaluate the temporal profile of arterial functions during the course of pregnancy and also to determine the predictive accuracy of vascular function indices in development of preeclampsia (PE). STUDY DESIGN: Longitudinal study, two hundred and eight women participated in the study and vascular functions were assessed at 11-13, 20-22 and 30-32 weeks of gestation. MAIN OUTCOME MEASURES: Flow mediated dilatation (FMD), augmentation index (AIx), pulse wave velocity (PWV). RESULTS: Out of 208 women, 13 women developed PE while 70 remained healthy pregnant (HP). In HP women, normalized FMD decreased gradually from 11 to 13 weeks to 30-32 weeks of gestation (p < 0.05). While in PE, Normalized FMD decreased from 11 to 13 to 20-22 weeks of gestation (p < 0.05) and was significantly lower in PE than HP group at 20-22 weeks of gestation (p < 0.05). AIx showed a mid trimester drop in HP group (p < 0.05) while demonstrated a rising trend in PE. Both AIx and PWV were significantly higher in PE than HP group during the course of pregnancy (p < 0.05). AIx demonstrated good sensitivity and specificity at both 11-13 and 20-22 weeks of gestation. Carotid femoral PWV showed an area under curve (AUC) of 78.18% and 69.75% at 11-13 and 20-22 weeks of gestation respectively. Carotid radial PWV showed good accuracy at 20-22 weeks (AUC-77.58%) of gestation. CONCLUSIONS: Compromised arterial functions precede the onset of PE. AIx and carotid femoral PWV constitute potential predictive marker in early pregnancy for later development of PE.
OBJECTIVE: To evaluate the temporal profile of arterial functions during the course of pregnancy and also to determine the predictive accuracy of vascular function indices in development of preeclampsia (PE). STUDY DESIGN: Longitudinal study, two hundred and eight women participated in the study and vascular functions were assessed at 11-13, 20-22 and 30-32 weeks of gestation. MAIN OUTCOME MEASURES: Flow mediated dilatation (FMD), augmentation index (AIx), pulse wave velocity (PWV). RESULTS: Out of 208 women, 13 women developed PE while 70 remained healthy pregnant (HP). In HP women, normalized FMD decreased gradually from 11 to 13 weeks to 30-32 weeks of gestation (p < 0.05). While in PE, Normalized FMD decreased from 11 to 13 to 20-22 weeks of gestation (p < 0.05) and was significantly lower in PE than HP group at 20-22 weeks of gestation (p < 0.05). AIx showed a mid trimester drop in HP group (p < 0.05) while demonstrated a rising trend in PE. Both AIx and PWV were significantly higher in PE than HP group during the course of pregnancy (p < 0.05). AIx demonstrated good sensitivity and specificity at both 11-13 and 20-22 weeks of gestation. Carotid femoral PWV showed an area under curve (AUC) of 78.18% and 69.75% at 11-13 and 20-22 weeks of gestation respectively. Carotid radial PWV showed good accuracy at 20-22 weeks (AUC-77.58%) of gestation. CONCLUSIONS: Compromised arterial functions precede the onset of PE. AIx and carotid femoral PWV constitute potential predictive marker in early pregnancy for later development of PE.