Angiogenic factors and uterine Doppler velocimetry in early- and late- onset preeclampsia

作者：Tobinaga Clarissa M; Torloni Maria R; Gueuvoghlanian Silva Barbara Y; Pendeloski Karen P T; Akita Patricia A; Sass Nelson; Daher Silvia^*

来源：Acta Obstetricia et Gynecologica Scandinavica, 2014, 93(5): 469-476.

DOI：10.1111/aogs.12366

• Angiogenesis
• uterine perfusion
• preeclampsia
• ultrasonography
• Doppler
• blood flow

ObjectiveTo assess correlations between maternal serum levels of pro- and anti-angiogenic factors with uterine perfusion in women with early- compared with late-onset preeclampsia, and in healthy pregnant women.
DesignCase-control study.
SettingAntenatal care clinic located within a hospital (SAo Bernardo do Campo, Brazil).
PopulationWe enrolled 54 preeclamptic and 54 healthy control women who were coming for routine ultrasound at 28-36weeks' gestation.
MethodsAll participants had uterine artery and umbilical Doppler studies and a blood sample to assess maternal serum levels of soluble fms-like tyrosine kinase-1, soluble endoglin, adiponectin and plasminogen activator inhibitor-1. All angiogenic factors were measured using enzyme-linked immunosorbent assay.
Main outcome measuresLevels of pro- and anti-angiogenic factors in maternal serum, and uterine artery Doppler findings.
ResultsConcentrations of soluble fms-like tyrosine kinase-1 and soluble endoglin were significantly higher in preeclamptic than control women (p<0.0001 and p<0.0001, respectively), especially in those with early-onset (<34weeks) preeclampsia. These two anti-angiogenic mediators were significantly correlated with increased uterine artery Doppler in the preeclamptic women. Plasminogen activator inhibitor-1 levels were significantly higher in preeclampsia (p=0.03) but unrelated to uterine artery resistance. Adiponectin levels were similar in cases and controls, independent of body mass index and unrelated to uterine artery resistance.
ConclusionPreeclamptic patients have increased soluble fms-like tyrosine kinase-1 and soluble endoglin serum levels and this increase is directly correlated with uterine artery resistance, especially in those with early-onset preeclampsia.

• 出版日期2014-5