Uteroplacental blood flow and placental vascular endothelial growth factor in normotensive and pre‐eclamptic pregnancy

Publisher Website
Google Scholar
Abstract
Objective To determine whether placental vascular endothelial growth factor (VEGF) is increased in pre‐eclampsia.Design Prospective cohort study.Setting Royal Prince Alfred Hospital, Sydney, Australia.Sample Eleven normotensive women and eight women with pre‐eclampsia matched for age and gestation.Methods Uterine artery Doppler ultrasound flow velocity profiles were recorded in the third trimester and resistance index calculated as (Vs‐Vd)/Vs (Vs= peak systolic flow velocity, Vd= end diastolic flow velocity). Placental tissue at delivery was examined for VEGF distribution with avidin‐biotin‐peroxidase immunohistochemistry.Results Uterine resistance index [median (range)] was significantly increased in pre‐eclamptic women (normotensive: 0.42 (0.36–0.51); pre‐eclampsia: 0.59 (0.40–0.75); P= 0.005). Notching of the uterine artery waveform, consistent with a high resistance circulation, was evident in early diastole in five women with pre‐eclampsia but only one normotensive woman (P= 0.013). Placental VEGF was increased in women with pre‐eclampsia in the decidual trophoblast (normotensive: 34% (4–59) cells stained for VEGF; pre‐eclampsia: 58% (15–95); P= 0.033) and in the villous syncytiotrophoblast (normotensive: VEGF count 1.4 arbitrary units (1.1–2.1); pre‐eclampsia: 1.8 arbitrary units (1.4–2.2); P= 0.041). Analysis indicated that uterine artery resistance index was directly correlated with placental VEGF staining, mean arterial pressure and birthweight.Conclusions Abnormal uterine artery Doppler ultrasound flow velocity profiles in pre‐eclampsia indicate increased uteroplacental resistance. The associated increase in placental VEGF may represent a compensatory mechanism attempting to restore blood flow towards normal.

This publication has 22 references indexed in Scilit: