Home Uteroplacental circulation, preeclampsia, and maternal abdominal aortic stiffness in normal and compromised pregnancies
Article
Licensed
Unlicensed Requires Authentication

Uteroplacental circulation, preeclampsia, and maternal abdominal aortic stiffness in normal and compromised pregnancies

  • Uchida Noa , Mori Akira , Togo Atsuko , Ishiguro Yoko and Mikami Mikio
Published/Copyright: April 1, 2007
Journal of Perinatal Medicine
From the journal Volume 35 Issue 2

Abstract

A study of 82 normal and 60 compromised pregnant women who were identified by uterine artery Doppler flow waveform systolic/diastolic ratio >95th percentile (increased peripheral resistance) was carried out to examine the elastic properties of the maternal abdominal aorta (AA). An aortic stiffness index (SI) was measured between 18 and 40 weeks at four-weekly intervals with a phase-locked loop ultrasound technique to estimate the aortic systolic and diastolic diameters and their correlation with blood pressure. In the normal group, the aortic systolic and diastolic diameters, as well as the SI, increased with the maternal age. In the compromised group, aortic diameter and blood pressure were normal, but the SI during the early second trimester was increased. Twenty-two women from the compromised group with an SI above the 95th percentile for their age had a significantly higher prevalence of preeclampsia in comparison with women with a normal SI (P<0.001). The aortic SI was significantly higher in severe than in mild preeclampsia. This study demonstrates that stiffness of the AA is increased in pregnant women with preeclampsia and that a progressive increase of the SI in serial studies is associated with severity of the disease. Aberrant hemodynamic adaptation in preeclampsia seems to include increased stiffness of the larger artery besides high resistance in small peripheral arteries.

:

Corresponding author: Akira Mori, MD Tokai University School of Medicine Maternal and Perinatal Center Department of Obstetrics and Gynecology Bohseidai, Isehara Kanagawa, 259-1193, Japan Tel.: +81-463-93-1121 Fax: +81-463-91-4343

References

1 Altman D: Construction of age-related reference centiles using absolute residuals. Stat Med12 (1993) 91710.1002/sim.4780121003Search in Google Scholar PubMed

2 Anim-Nyame N, SR Sooranna, MR Johnson, J Gamble, PJ Streer: A longitudinal study of resting peripheral blood flow in normal pregnancy and pregnancies complicated by chronic hypertension and pre-eclampsia. Cardiovasc Res50 (2001) 603Search in Google Scholar

3 Barden AE, Beilin LJ, Ritchie J, Walters BN, Michael C: Does a predisposition to the metabolic syndrome sensitize women to develop pre-eclampsia? J hypertension17 (1999) 1307Search in Google Scholar

4 Boutouyrie P, Y Bezie, P Lacolley, P Challande, P Chamiot-Clerc, A Benetos, et al.: In vivo/in vitro comparison of rat abdominal aorta wall viscosity: influence of endothelial function. Arterioscler Thromb Vasc Biol17 (1997) 1346Search in Google Scholar

5 Browyer L, MA Brown, M Jones: Forearm blood flow in pre-eclampsia. Br J Obstet Gynecol110 (2003) 383Search in Google Scholar

6 Darne B, X Girerd, M Safar, F Cambien, L Guze: Pulsatile versus steady component of blood pressure; a cross-sectional analysis of a prospective analysis of cardiovascular mortality. Hypertension13 (1989) 392Search in Google Scholar

7 Halligan A, J Bonner, B Sheppard, M Darling, J Walshe: Haemostatic fibrinolytic and endothelial variables in normal pregnancies and pre-eclampsia. Br J Obstet Gynecol101(1994) 48810.1111/j.1471-0528.1994.tb13147.xSearch in Google Scholar PubMed

8 Hanretty KP, MH Primrose, JP Neilson, MJ Whittle: Pregnancy screening by Doppler uteroplacental and umbilical artery waveforms. Br J Obstet Gynaecol96 (1998) 1163Search in Google Scholar

9 Hayashi K, M Sato, H Handa, K Moritake: Biomechanical study of the constitutive laws of vascular walls. Experimental Mechanics14 (1974) 440Search in Google Scholar

10 Hayashi K, H Handa, S Nagasawa, A Okumura, K Moritake: Stiffness and elastic behavior of human intracranial and extracranial arteries. J Biomechanics13 (1980) 175Search in Google Scholar

11 Kawasaki T, S Sasayama, SI Yagi, T Asakawa, T Hirai: Non-invasive assessment of the age related changes in stiffness of major branches of the human arteries. Cardiovasc Res21 (1987) 678Search in Google Scholar

12 Liao D, DK Arnett, HA Tyroler, WA Riley, LE Chambless, M Szklo, et al.: Arterial stiffness and the development of hypertension: the ARIC study. Hypertension34 (1999) 201Search in Google Scholar

13 Lyall F, LA Greer: Pre-eclampsia: a multifaceted vascular disorder of pregnancy [review]. J Hypertension12 (1994) 1339Search in Google Scholar

14 MacCarthy AL, RG Woolfson, SK Raju, L Poston: Abnormal endothelial cell function of resistance arteries from women with preeclampsia. Am J Obstet Gynecol168 (1993) 1323Search in Google Scholar

15 Mori A, BJ Trudinger, R Mori, V Reed, Y Takeda: The fetal aortic pressure pulse waveform in normal and compromised pregnancy. Br J Obstet Gynecol104 (1997) 1255Search in Google Scholar

16 Poppas A, S Shroff, CE Korcarz, JU Hibbard, DS Berger, MD Lindheimer, et al.: Serial assessment of the cardiovascular system in normal pregnancy: role of arterial compliance and pulsatile arterial load. Circulation95 (1997) 2407Search in Google Scholar

17 Roberts JM, G Pearson, J Cutler, M Lindheimer: Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension41 (2003) 437Search in Google Scholar

18 Royston P: Constructing time specific reference ranges. Stat Med10 (1997) 67510.1002/sim.4780100502Search in Google Scholar PubMed

19 Schiff E, G Ben-Baruch, E Peleg: Immunoreactive circulating endothelin-1 in normal and hypertensive pregnancies. Am J Obstet Gynecol166 (1992) 624Search in Google Scholar

20 Seligman S, J Buyon, R Clancy: The role of nitric oxide in the pathogenesis of preeclampsia. Am J Obstet Gynecol171 (1994) 944Search in Google Scholar

21 Trudinger BJ, CM Cook: Doppler umbilical and uterine flow waveforms in severe pregnancy hypertention. Br J Obstet Gynaecol97 (1990) 278Search in Google Scholar

22 Trudinger BJ, CM Cook, WB Giles: Fetal umbilical artery velocity waveforms and subsequent neonatal outcome. Br J Obstet Gynaecol98 (1991) 378Search in Google Scholar

23 Valensise H, G Novelli, B Vasapollo, M Borzi, D Arduini, A Galante, et al.: Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study. Ultrasound Obstet Gynecol15 (2000) 487Search in Google Scholar

24 Wang J, S Mimuro, R Lahoud, B Trudinger: Elevated levels of lipoprotein(a) in women with preeclampsia. Am J Obstet Gynecol178 (1997) 146Search in Google Scholar

25 Wilkinson IB, H MacCallum, DF Rooijmans, GD Murray, JR Cockcroft, JA McKnight, et al.: Increased augmentation index and systolic stress in type 1 diabetes mellitus. QJM93 (2000) 441Search in Google Scholar

26 Zimmermann P, V Eirio, J Koskinen, E Kujansuu, T Ranta: Doppler assessment of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre-eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters. Ultrasound Obstet Gynecol9 (1997) 330Search in Google Scholar

Published Online: 2007-04-01
Published in Print: 2007-04-01

©2007 by Walter de Gruyter Berlin New York

Articles in the same Issue

  1. To all readers, authors and subscribers
  2. The relationship between periodontal disease, bacterial vaginosis, and preterm birth
  3. Does raising the glucose challenge test threshold impact birthweight in Asian gravidas?
  4. Puerperal complications following elective cesarean sections for twin pregnancies
  5. Fortified mineral water improves folate status and decreases plasma homocysteine concentration in pregnant women
  6. Milk iron content in breast-feeding mothers after administration of intravenous iron sucrose complex
  7. Uteroplacental circulation, preeclampsia, and maternal abdominal aortic stiffness in normal and compromised pregnancies
  8. Induction of labor with oral misoprostol for premature rupture of membranes at term in women with unfavorable cervix: a randomized, double-blind, placebo-controlled trial
  9. Reference intervals for the cross sectional area of the umbilical cord during gestation
  10. The combined effect of betamethasone and ritodrine on the middle cerebral artery in low risk third trimester pregnancies
  11. Association between peak serum bilirubin and severity of respiratory distress syndrome in infants of less than 30 weeks' gestation
  12. Ranitidine and late-onset sepsis in the neonatal intensive care unit
  13. Outcome of infants born at 21–28 weeks' gestation in an inner-city hospital over an eight-year period
  14. Detection rate of Helicobacter pylori stool antigen in newborn infants and small children
  15. The potential role of high or low birthweight as risk factor for adult schizophrenia
  16. Multiple vascular accidents: Pentalogy of Cantrell in one twin with left sided colonic atresia in the second twin
  17. Solitary hepatic lymphangioma in an infant
  18. Spontaneous twin pregnancy in a 56-year-old primipara
  19. Fetal behavior analyzed by ultrasonic actocardiogram in cases with central nervous system lesions
  20. Congress Calendar
Downloaded on 18.10.2025 from https://www.degruyterbrill.com/document/doi/10.1515/JPM.2007.038/html
Scroll to top button