Abstract
Introduction The underlying pathology of hypertensive pregnancy disorders is a failure in trophoblast invasion and spiral artery remodeling. This leads to a misbalanced release of antiangiogenic sFlt-1 and angiogenic PlGF placental factors and to a high resistance and low compliance to uterine artery blood flow. Consequently, in hypertensive pregnancy disorders, sFlt-1/PlGF ratio and uteroplacental impedance are increased. Objective To explore correlations between sFlt-1/PlGF ratio and uterine artery Doppler parameters in pregnancies complicated by different types of hypertensive pregnancy disorders. Patients and methods We performed prospective observational study to derive and calculate sFlt-1/PlGF ratio and to measure uterine artery resistance index (RI-AtU) and pulsatility index (PI-AtU) in singleton pregnancies in whom preeclampsia (PE), preeclampsia with intrauterine growth retardation (PE (+IUGR)), or intrauterine growth retardation (IUGR) was suspected on admittance after 24 weeks 0 days. For statistical analyses, we used multiple comparisons (Bonferroni test) and Sperman’s rho. Results Demographic and clinical characteristics are presented in Fig. 1. Values for sFlt-1/PlGF ratio, RI-AtU and PI-AtU are presented in Fig. 2. Log values of sFlt-1/PlGF ratio were not significantly different among groups. Average RI-AtU and PI-AtU were significantly higher in PE(+IUGR) compared to PE (p = 0.28; p = 0.05; respectively) but were not significantly different between IUGR and PE, or IUGR and PE (+IUGR). In PE, RI-AtU and PI-AtU were significantly positively correlated with sFlt-1/PlGF ratio (p = 0.01; p = 0.050; respectively). In IUGR, only RI-AtU was significantly positively correlated with sFlt-1/PlGF ratio (p = 0.041). In PE (+IUGR), neither RI-AtU nor PI-AtU were correlated with sFlt-1/PlGF ratio. Conclusion Differences in correlations between sFlt-1/PlGF ratio and uterine artery Doppler parameters suggest that PE might be a decompensation phase of beforehand healthy cardiovascular system due to uteroplacental vascular pathology. However, PE (+IUGR) and IUGR might be a consequence of various degrees of preexisting systemic cardiovascular pathology which might lead to various degrees of uteroplacental pathology. Download : Download high-res image (367KB) Download : Download full-size image Download : Download high-res image (349KB) Download : Download full-size image
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