OBJECTIVE: To identify possible differences between endothelial dysfunction evaluated by brachial artery flow-mediated dilation and central hyperperfusion evaluated by dopplerfluxometry of ophthalmic artery in women with early- and late-onset preeclampsia. MATERIALS AND METHODS: Flow-mediated dilation testing and dopplerfluxometry of ophthalmic artery were performed in 81 patients (26 with early preeclampsia, 30 with late preeclampsia, and 25 normotensive pregnant women – control group). RESULTS: As compared with the control group, patients with preeclampsia presented lower values of flow-mediated dilation, both in cases of early preeclampsia (7.62 ± 5.42% × 14.12 ± 6.14%; p = 0.02) and in cases of late preeclampsia (5.83 ± 4.12% × 14.12 ± 6.14%; p = 0.00). No statistically significant difference was observed between early- and late-onset preeclampsia (7.62 ± 5.42% × 5.83 ± 4.12%; p = 0.09). Values for dopplerfluxometry of ophthalmic artery were significant lower in patients with preeclampsia as compared with the control group, both in cases of early preeclampsia (0.631 ± 0.024 × 0.737 ± 0.032; p = 0.01) and in cases of late preeclampsia (0.653 ± 0.019 × 0.737 ± 0.032; p = 0.03). Again, no statistically significant difference was observed between early- and late-onset preeclampsia (0.631 ± 0.024 × 0.653 ± 0.019; p = 0.12). Basically, the results demonstrate a decrease in values for dopplerfluxometry of ophthalmic artery in patients with early and late presentations of preeclampsia as compared with the control group, although with no statistically significant difference between the two presentations of the disease. CONCLUSION: The present results indicate the presence of endothelial dysfunction and central hyperperfusion in patients with early- and late-onset preeclampsia.

Keywords: Preeclampsia; Flow-mediated dilation; Ophthalmic arteries.

OBJECTIVE: 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.

Keywords: Preeclampsia; Doppler flowmetry; Vascular endothelium; Prediction.

OBJECTIVE: To 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 METHODS: A 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. RESULTS: Nineteen 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. CONCLUSION: FMD 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.

Keywords: Preeclampsia; Ultrasonography; Vascular endothelium; Prediction.