title: [Maternal endothelial function in the course of pregnancy and postpartum - ultrasound-based longitudinal assessment using flow-mediated dilatation (FMD)].
abstract: OBJECTIVE
  NO-triggered vasodilatation decreases peripheral vascular resistance in pregnancy. Using a noninvasive ultrasound technique, flow-mediated vasodilatation can be quantified. We used this technique to detect changes in endothelial function during pregnancy and postpartum.
  
  
  METHODS
  In a prospective longitudinal study 16 healthy pregnant women were assessed for flow-mediated dilatation of the brachial artery during pregnancy (first trimester T 1 < 14th gestational week, second trimester T 2 ≥ 14th - 27th gestational week, third trimester T 3 ≥  28th gestational week) and postpartum (> 6 weeks postpartum). As a control group, flow-mediated dilatation was determined in 19 healthy non-pregnant women.
  
  
  RESULTS
  Flow-mediated dilatation (%) increased significantly in normal human pregnancy from the first trimester (T1 8.0 ± 5.58 vs. T 2 15.2 ± 5.19, p < 0.003) to the second trimester and reached its maximum in mid-trimester. Towards the end of pregnancy, flow-mediated dilatation decreased significantly (T2 vs. T 3 9.15 ± 3.61, p < 0.004). Mean values of flow-mediated dilatation are significantly higher during the second and third trimester of pregnancy compared to non-pregnant controls (T2 vs. NP 6.17 ± 4.39, p < 0.001; T 3 vs. NP, p < 0.047). Postpartum flow-mediated dilatation decreased to values of early pregnancy.
  
  
  CONCLUSIONS
  During pregnancy maternal endothelial function shows an increase in flow-mediated dilatation and then reverts postpartum. Using ultrasound-based measurement of flow-mediated dilatation, these physiological changes in pregnancy can be reliably detected.
authors.affiliation: Abteilung Geburtshilfe, Universitätsfrauenklinik, Jena.
authors.forename: C
authors.initials: C
authors.lastname: Seeliger
authors.forename: A
authors.initials: A
authors.lastname: Brueckmann
authors.forename: E
authors.initials: E
authors.lastname: Schleußner
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001810:Blood Volume / Q000502:physiology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D055424:Cardiac-Gated Imaging Techniques; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted; D009569:Nitric Oxide / Q000502:physiology; D015588:Observer Variation; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D012016:Reference Values; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014664:Vasodilation / Q000502:physiology*
chemical_list: D009569:Nitric Oxide