Vaso-active mediators and doppler indices in maternal and fetal vessels in pre-eclampsia

ABSTRACT

Pre-eclampsia is associated with increased vascular reactivity and vasoconstriction. Forty six women whose pregnancy were complicated with pre-eclampsia and twenty six normotensive pregnant women all at the same duration of pregnancy were studied. Pre-eclampsia occurred in the 2nd trimester only in two patients, in the sometime it occurred in 28 patients before the 37th weeks and 16 after the 37th weeks. Only eight patients were with moderate hypertension, while 38 patients were with severe disease. Blood flow velocity waveforms in both right and left uterine arteries, fetal umbilical artery and fetal descending aorta was done for both patients and controls. Serum levels of endothelin-I [ET1], prostaglandin E2 [PGE2], nitric oxide [NO], Von Willebrand factor [vWF] and angiotensin converting enzyme activities [ACE], were determined for both patients and controls. Serum levels of ET-1, ACE and vWF were higher, while serum levels of NO and PGE2 were lower to statistically significant levels [p<0.001] in pre-eclamptic women in all instances. Also, all Doppler indices were significantly higher in patients with pre-eclampsia than in normotensive women [p<0.001]. There was strong positive correlation between Doppler indices and serum levels of ET-1, ACE and vWP and strong negative correlation with NO and PGE2 in both patients with pre-eclampsia and in normotensive women [r<0.05]. These changes confirm the presence of highlight vascular reactivity and endothelial damage in cases of pre-eclampsia. The resulting endothelial damage and dysfunction may underlay the pathologic features of this disorder