The Detection Of Flow-mediated Vasodilation In Brachial Artery Of Nonpregnant And Pregnant Women

ObjectiveThe purpose of the detection of flow-mediated vasodilation technology (FMD)in women,s brachial artery who is non-pregnancy, normal pregnancy, pregnancy-induced hypertension and gestational diabetes mellitus is to discover and explore thechanges in vascular function; analysis the meaning and value in assessment ofvascular function,and to provide parameters for clinical diagnosis and treatment.MethodsWe performed the examinations with a7.0-12.0MHz linear transducer ofAloka-10ultrasound scanner.32cases non-pregnant women (15cases were repeatedmeasurements by the same operator at different times),77cases of first trimesterpregnancy women,40cases of second trimester pregnant women, and73cases ofthird trimester pregnancy women (38cases of normal pregnant,20cases of pregnantwomen with hypertensive disorders,15cases of gestational diabetes mellitus）between March2012and March2014were examined.The purpose of the etection isto compare the changes of FMD.The results were statistically analyzed with P<0.05indicating significant differerces.Results1、The consistency of branchial FMD measurements were significant in the sameoperator on the the repeated measurement.2、The value of FMD of Normal non-pregnant is7.66±2.74%, the first,secondand third trimester pregnant are11.06±3.74%,9.32±3.61%,8.26±3.13%.Compared tononpregancy,FMD of the first,second and third trimester pregnant increased by44.39%,21.67%,7.83%. FMD values between first trimester pregnancy group andnon-pregnant group, first trimester pregnancy and second trimester pregnancygroup,first trimester pregnancy and third trimester pregnancy were significant differerces(P<0.05);the FMD values between other groups were no significantdifference (P>0.05).3、The value of FMD of hypertensive disorders in pregnancy in third trimesterpregnancy is5.94±3.75%. And there was a significant difference (t=2.51, P <0.05)with normal group in third trimester pregnancy.The value of FMD of gestational diabetes mellitus in third trimester pregnancy is5.83±3.81%. And there was a significant difference (t=2.39，P <0.05) with normalgroup in third trimester pregnancy.But there is not significant difference between hypertensive disorders inpregnancy and gestational diabetes mellitus.Using the cutoff values of7.40%、7.39%for diagnosis of hypertensive disorder in pregnancy,gestational diabetes mellitus,thecorresponding AUCs were0.71,0.73,respectively.Conclusions1、The measurement of FMD is repeatable, the mode of automatic tracking tomeasure vascular max diameter avoid the time-dependence,experience-dependenceand individual differences of subjects,and minimize operating’s subjection,the resultsis objection and true.2、In normal pregnancy, maternal brachial artery FMD is affected by the differentages of pregnancy.with increasing gestational ages,FMD values decreased. The valuesof FMD in hypertensive disorder in pergnancy or gestational diabetes mellitusdecreased.3、 The results of this study showed that the measurement of FMD of thebrachial artery can reflects the reactivity of vascular endothelial cells.With its easyoperation、time saving and non-invasive，it is able to be a method of evaluation ofendothelial cell function.