VASCULAR STATUS AND PHYSIOLOGICAL PREGNANCY

Abstract

Objective: Recently, there has been interest of researchers in assessing vascular stiffness in various complications of pregnancy (P). However, there is little data on profile of this parameter in healthy pregnants. Purpose: to assess the dynamics of the main indicators of vascular stiffness in physiological P. Design and method: Prospective longitudinal study was performed. 95 women with singleton pregnancies aged 18 to 23 years were examined. Exclusion criteria: BMI at beginning of pregnancy >25 kg/ m2; any somatic disease, all variants of hypertension (including those developed during pregnancy), smoking, infectious diseases, multiple pregnancy, as well as pregnancy resulting from assisted reproductive technologies. The control group consisted of 45 healthy young non-pregnant women, comparable in age and anthropometric data. Non-invasive assessment of vascular stiffness was performed by oscillometric method on apparatus BpLab Vasotens (Peter Telegin, Russia). The device complies with international accuracy standards for oscillometric BP recorders and is recommended for use in pregnant women. Estimated parameters such as augmentation index in brachial artery (AIX,%), augmentation index in aorta (AIXao,%), pulse wave velocity in aorta (PWVao, m/s). Measurements were taken several times at different gestation periods. Results: Parameters of vascular stiffness in healthy pregnants differed significantly from those in control. Thus, AIX in the brachial artery during P had significantly lower values regardless of gestation. Its dynamics has following features: the decrease of this indicator from very beginning of the P, maximum decrease was recorded between 25 and 30 weeks, then its value increased, but did not reach the control values. AIXao in healthy pregnant women was also significantly lower. Maximum reduction occurred at same time as for peripheral AIX. In healthy P, there was a lower RWVao. Dynamics of this indicator had more complex picture: lowest value was observed between 15 and 20 weeks, then RWVao increased, reaching maximum by 35 weeks, followed by slight decrease. Conclusions: There is clear dependence of vascular stiffness on timing of gestation, which is due to a whole complex of physiological changes occurring in body of pregnants. Obtained data are useful for improving system of cardiovascular support for pregnants.