Key result
Third-trimester flow-mediated vasodilatation is linked to ~30% higher risk of gestational hypertension and preeclampsia.
Why the study?
Assessment of endothelial dysfunction by flow-mediated dilatation for prediction of gestational hypertension and preeclampsia was needed.
Does serial assessment of flow-mediated vasodilatation predict the development of gestational hypertension or preeclampsia in primigravida women?
Cohort (n=654)
Does serial assessment of flow-mediated vasodilatation predict the development of gestational hypertension or preeclampsia in primigravida women?
Odds Ratio: 1.303 (95% CI 1.088–1.562)
p-value: p=0.004
Serial assessment of flow-mediated vasodilatation demonstrates a more marked decrease in women developing gestational hypertension/preeclampsia, suggesting its utility as a non-invasive predictive marker.
May support non-invasive prediction of gestational hypertension and preeclampsia; hypothesis-generating and requires prospective validation before clinical adoption.
OBJECTIVE: Assessment of endothelial dysfunction for prediction of gestational hypertension/preeclampsia (GH/PE). METHODS: Serial assessment of flow-mediated vasodilatation (FMD) of brachial artery was done in first, second, and third trimesters, and within 6 weeks of delivery in primigravida (n = 654). Logistic regression was used to assess the predictive value of FMD for the development of GH/PE. RESULTS: Significant fall in FMD was observed from first trimester to third trimester but decrease in FMD in GH/PE group (57%) was more marked as compared to normal (39%) (p < 0.01). FMD (third trimester) was able to predict the development of GH/PE (OR = 1.303; 95% CI 1.088-1.562; p = 0.004). CONCLUSIONS: FMD can be used as a non-invasive marker to predict the development of GH/PE.
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Malhotra et al. (2018) conducted a cohort in Gestational hypertension and preeclampsia (n=654). Flow-mediated vasodilatation (FMD) was evaluated on Development of gestational hypertension/preeclampsia (GH/PE) (OR 1.303, 95% CI 1.088-1.562, p=0.004). Third-trimester flow-mediated vasodilatation significantly predicted the development of gestational hypertension and preeclampsia (OR 1.303; 95% CI 1.088-1.562; p=0.004).
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