title: Brachial artery flow mediated dilation and pulsatility index change as independent predictors for hypertensive disorders in the second trimester of pregnancy.
abstract: OBJECTIVE
  To assess brachial artery flow mediated dilatation (FMD) and pulsatility index change (PIC) as independent parameters for prediction hypertensive disorders (preeclampsia - PE and gestational hypertension - GH) in the second trimester of pregnancy.
  
  
  METHODS
  We performed a prospective cohort study with 372 singleton pregnant women who underwent routine second trimester morphology scan. FMD and PIC were measured immediately after the ultrasound scan using the following formulas: FMD (%)=[(post occlusion arterial diameter-baseline arterial diameter)/baseline arterial diameter]×100 and PIC (%)=[(pulsatility index pre-pulsatility index post)/pulsatility index pre]. The control and hypertensive disorder groups were compared using the Kruskal-Wallis to continue variables and Chi-square and Fisher exact tests to categorical variables. We assessed the predictive accuracy of FMD and PIC by the area under the receiver operating characteristics (ROC) curve with its respective 95% confidence interval (CI).
  
  
  RESULTS
  We did not observe statistical difference between control and hypertensive disorder groups regarding the FMD and PIC (p=0.17 and p=0.38, respectively). Areas under ROC curve for prediction of GH using FMD and PIC were 0.59 (CI95% 0.48-0.71) and 0.60 (CI95% 0.47-0.73), respectively. Areas under ROC curve for prediction of PE using FMD and PIC were 0.55 (CI95% 0.46-0.64) and 0.52 (CI95% 0.61-0.69), respectively.
  
  
  CONCLUSIONS
  Brachial artery FMD and PIC as independent parameters did not show good prediction for hypertensive disorders in the second trimester of pregnancy.
authors.affiliation: Department of Public Health, State University of Ceará (UECE), Fortaleza-CE, Brazil.
authors.forename: Paulo César
authors.initials: PC
authors.lastname: Praciano De Sousa
authors.affiliation: Department of Public Health, State University of Ceará (UECE), Fortaleza-CE, Brazil.
authors.forename: Júlio Augusto
authors.initials: JA
authors.lastname: Gurgel Alves
authors.affiliation: Department of Public Health, State University of Ceará (UECE), Fortaleza-CE, Brazil.
authors.forename: Sammya
authors.initials: S
authors.lastname: Bezerra Maia E Holanda Moura
authors.affiliation: Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil. Electronic address: araujojred@terra.com.br.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo (DGO-FMRP-USP), Ribeirão Preto-SP, Brazil.
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne and Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, Victoria, Australia; Monash Ultrasound for Women, Melbourne, Victoria, Australia.
authors.forename: Fabricio
authors.initials: F
authors.lastname: Da Silva Costa
mesh_terms: D000328:Adult; D001916:Brachial Artery / Q000503:physiopathology*; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D011673:Pulsatile Flow; D012372:ROC Curve; D016216:Ultrasonography, Prenatal; D014664:Vasodilation
keywords: Brachial artery; Flow mediated dilatation; Prediction; Preeclampsia; Pulsatility index change; Second trimester