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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-28012020-102325
Document
Author
Full name
Hellen Cristiane Grepi Okano
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Cavalli, Ricardo de Carvalho (President)
Francisco, Rossana Pulcineli Vieira
Marcolin, Alessandra Cristina
Sandrim, Valéria Cristina
Title in Portuguese
Avaliação da qualidade endotelial dos vasos sanguíneos e do tônus arterial em mulheres grávidas com disfunções hipertensivas
Keywords in Portuguese
Endo-PAT
Hipertensão crônica na gestação
Pré-eclâmpsia
Tonometria
Velocidade de onda de pulso (VOP)
Abstract in Portuguese
As desordens hipertensivas na gestação afetam aproximadamente de 5 a 8% das gestantes em todo o mundo, contribuindo de forma significativa para complicações materno-fetais graves. A saúde do endotélio vascular, bem como a complacência arterial periférica no processo gestacional, garante menor risco de desenvolvimento de patologias associadas a doenças cardiovasculares e descontrole nos níveis pressóricos, garantindo boa perfusão uteroplacentária e bom desenvolvimento fetal. Este estudo teve como objetivo avaliar as alterações no endotélio vascular da gestante com hipertensão arterial crônica e pré-eclâmpsia, por meio dos exames Proteína C reativa, Endo-PAT e velocidade de onda de pulso (VOP). Foram avaliadas 72 gestantes, dividas em 3 grupos de 24 pacientes: Grupo I - sem desordem vascular, Grupo II - hipertensão crônica na gestação (HAC) e Grupo III - pré-eclâmpsia (PE). Os resultados deste estudo para disfunção endotelial, considerando valores superiores a 0,5 lnRHI como parâmetro mínimo de normalidade, tiveram (0,57±0,24; 0,59±0,26; 0,62±0,2 com P>0,1957). Para rigidez arterial periférica, considerando PWV=5 m/s - parâmetro de normalidade, tivemos (5,98 ±1,02; 7,99 ± 3,04; 8,87±1,92 com P<0,0001 entre os grupos I e II, I e III, porém entre II e III não houve diferença estatística). Para PCR, concentrações até 0,5 são normais, tivemos (0,30±0,2; 0,81±0,69; 1,25±1,23 P< 0.0020). Gestantes com hipertensão crônica e pré-eclâmpsia apresentaram características de parâmetros clínicos e laboratoriais alterados, elevadas taxas de parto cesárea e identificamos que as gestantes normotensas também apresentaram alterações no endotélio vascular. Nosso trabalho reforça os dados da literatura sobre a função do endotélio vascular íntegro na gestação, o que garante nutrição ao feto. Além disso, concluímos que a identificação precoce de disfunção endotelial permite o início de medidas preventivas para minimizar o risco de hipertensão gestacional
Title in English
Evaluation of the endothelial quality of the blood vessels and of arterial tone in pregnant women with hypertensive dysfunctions
Keywords in English
Chronic hypertension during pregnancy
Endo-PAT
Pre-eclampsia
Pulse Wave Velocity VOP)
Tonometry
Abstract in English
Hypertensive disorders in pregnancy affect approximately 5 to 8% of pregnant Hypertensive disorders in pregnancy affect approximately 5 to 8% of pregnant women, contributing significantly to severe maternal-fetal complications. The vascular endothelium health, as well as the peripheral arterial compliance in the gestational process ensure a lower risk of development of pathologies associated with cardiovascular diseases and uncontrolled pressure levels, improving a better uteroplacental perfusion and fetal development. The aim of this study was to evaluate the changes in the vascular endothelium of pregnant women with chronic hypertension during pregnancy and preeclampsia using the tests Protein C reactive, Endo-PAT and pulse wave velocity. Seventy-two pregnant women, divided into three groups of 24 patients, were evaluated: Group I - No vascular disorder, Group II - Chronic Hypertension in Pregnancy (CHP) and Group III - Preeclampsia (PE). The results of this dissertation were endothelial, as values above 0.5 lnRHI were considered normal thresholds (0.57 ± 0.24; 0.59 ± 0.26; 0.62 ± 0.2 P> 0, 1957). Mean arterial stiffness was 5.00 ± 1.02; 7.99 ± 3.04; 8.87 ± 1.92 with P <0.0001 .... For PCR, it has up to 0.3 minutes (0.30 ± 0.2; 0.81 ± 0.69; 1.25 ± 1 , 23 P <0.0020). Chronic hypertension and preeclampsia were characterized as related clinical and laboratory variables, with labor participation rates and we identified as normotensive pregnant women also end changes in vascular endothelium. The data are in accordance with other studies on vascular endothelial function in pregnancy, which ensures better nutrition to the fetus. In addition, we concluded that early detection of endothelial dysfunction allows the initiation of preventive measures to minimize the risk of gestational hypertension
 
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Publishing Date
2020-03-18
 
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