Avaliação da função endotelial em gestantes portadoras de pré-eclâmpsia e diabetes mellitus gestacional através da dilatação fluxo-mediada da artéria braquial

Abstract

Background: Although several advances have already been achieved in to the diagnosis and treatment of typical diseases of gestation, Preeclampsia (PE) and Gestational Mellitus Diabetes (GMD) are still responsible for a large number of fetal and maternal mortality and morbidity. It is known that endothelial injury plays a key role on the pathophysiology of both diseases, characterized by a lower production and action of nitric oxide on vascular endothelium. The flow-mediated dilation (FMD) is a method of endothelial function´s evaluation in humans, being attractive for being non-invasive and with good results already published. Objectives: to compare the endothelial function, evaluated by FMD, in pregnant women with PE, GMD and healthy pregnant women. Patients and Methods: Eighty pregnant women were selected and divided into three groups: Group A: 42 pregnant women with PE, Group B (control): composed of 19 healthy pregnant women and Group C: composed of 19 pregnant women with GMD. FMD test was performed in all patients and the results between the groups were compared. Results: the analysis of variance nonparametric analysis of variance showed difference between groups of FMD (p = 0.00). Dunn test showed that the control group (average of FMD = 17.55 ± 8.35%) has higher values of FMD than the PE group (FMD = 5.36 ± 4.61%; p = 0.05) and GMD group (FMD = 9.18 ± 5.98%; p<0.05). The comparison between the groups PE x GMD did not provide statistical difference. The Group composed of pregnant women with GMD or PE has lower results of FMD than the control group (6.55 ± 5.33%; 17.55 ± 8.35%; p = 0.00). Conclusion: the lower values of FMD in groups of pregnant women with PE and GMD suggest endothelial injury in these patients