Correlation between maternal hemodynamic and sFlt-1/PlGF ratio in pregnancies affected by hypertensive disorders and fetal growth restriction.

OBJECTIVES

Our aim was to investigate the correlation between maternal hemodynamic and sFlt1/PlGF ratio in different phenotypes of Hypertensive Disorders of Pregnancy and Fetal Growth Restriction.

STUDY

DESIGN

We recruited high risk pregnancies for Hypertensive Disorders and Fetal Growth Restriction. Heart rate, cardiac output, total vascular resistance and myocardial wall relaxation were derived from transthoracic echocardiography. Doppler Velocimetry of uterine arteries and serum sFlt1/PlGF ratio were measured.

MAIN OUTCOMES MEASURES: The effect of maternal hemodynamic on the oxidative stress of the syncytiotrophoblast was proved by the significant correlation coefficient of the linear regression between sFlt-1/PlGF ratio with mean arterial pressure, heart rate, cardiac output, total vascular resistance, myocardial wall relaxation and uterine arteries' pulsatility index, which showed the highest correlation coefficient.

RESULTS

We identified 17 cases of Hypertensive Disorders of Pregnancy without Fetal Growth Restriction, 19 hypertensive patients with Fetal Growth Restriction, 25 cases of early Fetal Growth Restriction, 25 cases of late Fetal Growth Restriction and 16 controls. At univariate linear regression the sFlt-1/PlGF ratio significantly increased on average 85 times (+8549%) in case of hypertension associated with growth restriction, 17 times in case of isolated hypertension (+1681%), 6 times in early growth restriction (661%) and more than 5 times in the late form (542%). There was a correlation between sFlt-1/PlGF ratio and both uterine arteries' pulsatility index (ρ=0.48) and mean arterial pressure (ρ=0.45).

CONCLUSIONS

There is a significant relationship between maternal hemodynamic and sFlt-1/PlGF ratio, confirming the different characteristics of patients affected by hypertension and/or fetal growth restriction.