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

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Tobinaga, Clarissa M. [UNIFESP]
Torloni, Maria R. [UNIFESP]
Gueuvoghlanian-Silva, Barbara Y. [UNIFESP]
Pendeloski, Karen P. T. [UNIFESP]
Akita, Patricia A. [UNIFESP]
Sass, Nelson [UNIFESP]
Daher, Silvia [UNIFESP]
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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.
Acta Obstetricia Et Gynecologica Scandinavica. Hoboken: Wiley-Blackwell, v. 93, n. 5, p. 469-476, 2014.