title: Endothelial function, uterine perfusion and central flow in pregnancies complicated by Preeclampsia.
abstract: BACKGROUND
  The physiopathology of Preeclampsia (PE) is characterized by a deficiency in the process of placentation, systemic endothelial dysfunction and Central Nervous System (CNS) hyperflow. From a clinical point of view, it would be interesting to determine the occurrence of these phenomena before the onset of clinical manifestations of the disease, raising the possibility of new methods for predicting PE.
  
  
  OBJECTIVE
  Compare the process of placentation, endothelial function and CNS hyperflow in pregnant women at high risk for the development of PE who subsequently developed or not the syndrome.
  
  
  METHODS
  A total of 74 pregnant women underwent the Flow-Mediated Dilation (FMD) of the brachial artery, Doppler study of uterine and ophthalmic arteries for the assessment of endothelial function, process of placentation and central hyperflow, respectively. The examinations were performed between 24 and 28 weeks of gestation and were followed until the postpartum period for data collection.
  
  
  RESULTS
  Fifteen patients had PE and 59 remained normotensive until the puerperium. Patients who subsequently developed PE had between 24 and 28 weeks of gestation, higher pulsatility index of uterine arteries and lower values of FMD (p < 0.001 and p = 0.001, respectively). However, there was no difference in the values obtained in the resistive index in the ophthalmic artery (p = 0.08).
  
  
  CONCLUSIONS
  The data obtained suggest that the deficiency in the process of placentation and endothelial dysfunction chronologically precede the clinical manifestations of PE, which does not occur with CNS hyperflow.
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. augustohfbrandao@hotmail.com
authors.forename: Augusto Henriques Fulgêncio
authors.initials: AH
authors.lastname: Brandão
authors.forename: Marcelo Araújo
authors.initials: MA
authors.lastname: Cabral
authors.forename: Henrique Vitor
authors.initials: HV
authors.lastname: Leite
authors.forename: Antônio Carlos Vieira
authors.initials: AC
authors.lastname: Cabral
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000503:physiopathology; D002490:Central Nervous System / Q000098:blood supply / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000098:blood supply / Q000503:physiopathology; D010929:Placentation / Q000502:physiology; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055988:Uterine Artery / Q000503:physiopathology; D014599:Uterus / Q000098:blood supply / Q000503:physiopathology*