HYPEREMIC RESPONSE OF THE BRACHIAL-ARTERY DURING THE 2ND HALF OF PREGNANCY

OBJECTIVE: To determine if women who developed preeclampsia had measur able differences in the vascular response postrelease of a 1-minute bl ood flow occlusion. METHODS: A total of 33 nulliparous patients were e nrolled in this study during the second half of the pregnancy. All had baseline Doppler flow velocities while resting in the left lateral de cubitus. Subsequently, a blood pressure cuff was inflated for 60 secon ds in the forearm so as to occlude blood flow. Doppler waveforms were analyzed immediately after the release of the blood pressure cuff and on a single beat occurring at 15 second intervals for a total of five readings. After a rest period, patients were asked to squeeze a handhe ld manometer at maximum strength as long as possible. Doppler waveform s were as above. The Doppler waveforms of all enrolled patients who su bsequently developed preeclampsia any time after the study were compar ed to those who remained normotensive. RESULTS: 1) The ''hyperemic res ponse'' that occurred immediately after release of the blood pressure occlusion of the forearm was significantly different between patients who subsequently developed preeclampsia compared with those who remain ed normotensive, 2) the hyperemic response that occurred after the iso metric handgrip exercise was not significantly different between the t wo groups, and 3) sensitivity, specificity, and negative predictive va lues were high, but positive predictive values were low. CONCLUSION: T here was a significant difference in the hyperemic response of the bra chial artery to a short period of ischemia of the forearm (blood press ure occlusion) between normotensive patients and a group of patients w ho subsequently developed preeclampsia. Copyright (C) 1998 by the Soci ety for Gynecologic Investigation.