Systemic and placental hemodynamics in preeclampsia

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Abstract

Objective: To examine the characteristics of systemic and placental hemodynamics in women with preeclampsia.

Materials and methods: This case-control study was based on a prospective cohort study that included 95 pregnant women. The women were divided into three groups: group 1 (n=29) consisted of women without preeclampsia, group 2 (n=32) consisted of pregnant women with moderate preeclampsia, and group 3 (n=34) consisted of pregnant women with severe preeclampsia. This study examined the results of assessing uteroplacental-fetal hemodynamics and fetal biometric parameters, brachial artery endothelium-dependent vasodilation during pregnancy, arterial stiffness indices (CAVI), and vascular age at 6–8 weeks postpartum.

Results: Women with preeclampsia had primary hemodynamic disorders associated with chronic arterial hypertension and a history of preeclampsia. Severe preeclampsia in the second trimester was linked to changes in uterine and fetal blood flow, as well as fetal growth restriction. After brachial artery compression, the percentage increase in brachial artery diameter in patients with severe preeclampsia was pathologically low (4.8%). In severe preeclampsia, the brachial artery diameter after decompression was negatively correlated with uterine and umbilical cord blood flow and severe asphyxia of the newborn, and positively correlated with gestational age at delivery and the newborn Apgar score. At 6–8 weeks postpartum, women with preeclampsia still had significantly higher blood pressure, CAVI, and vascular age than normotensive women. There were negative correlations between CAVI and Apgar score, while positive correlations were found with biological age, body mass index, baseline (first trimester of pregnancy), and current (6–8 weeks postpartum) blood pressure levels.

Conclusion: Characteristics of endothelial dysfunction have been proposed as potential early diagnostic markers for preeclampsia and its consequences. Identification of these markers may allow timely initiation of preventive and therapeutic measures.

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About the authors

Valentina F. Dolgushina

South Ural State Medical University, Ministry of Health of the Russian Federation

Email: dolgushinavf@yandex.ru
ORCID iD: 0000-0002-3929-7708

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Russian Federation, Chelyabinsk

Elena G. Syundyukova

South Ural State Medical University, Ministry of Health of the Russian Federation; Clinic of the South Ural State Medical University

Email: seg269@mail.ru
ORCID iD: 0000-0001-9535-1871

Dr. Med. Sci., Associate Professor, Professor; Obstetrician-Gynecologist

Russian Federation, Chelyabinsk; Chelyabinsk

Vasily S. Chulkov

Yaroslav the Wise Novgorod State University

Email: vschulkov@rambler.ru
ORCID iD: 0000-0002-0952-6856

Dr. Med. Sci., Associate Professor, Professor at the Department of Internal Diseases

Russian Federation, Veliky Novgorod

Maria G. Ryabikina

Clinic of the South Ural State Medical University

Author for correspondence.
Email: mryabikina@mail.ru
ORCID iD: 0000-0003-0943-0448

obstetrician-gynecologist

Russian Federation, Chelyabinsk

Mikhail S. Kirsanov

Clinic of the South Ural State Medical University

Email: kirsmikhail@gmail.com

doctor of ultrasound diagnostics, Head of the Cabinet of Perinatal Giagnostics

Russian Federation, Chelyabinsk

Vladislas S. Chulkov

South Ural State Medical University, Ministry of Health of the Russian Federation

Email: vlad.chulkov.1989@mail.ru
ORCID iD: 0000-0002-1948-8523

PhD, Associate Professor at the Department of Faculty Therapy

Russian Federation, Chelyabinsk

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