Document Detail


High-end arteriolar resistance limits uterine artery blood flow and restricts fetal growth in preeclampsia and gestational hypertension at high altitude.
MedLine Citation:
PMID:  21325643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The reduction in infant birth weight and increased frequency of preeclampsia (PE) in high-altitude residents have been attributed to greater placental hypoxia, smaller uterine artery (UA) diameter, and lower UA blood flow (Q(UA)). This cross-sectional case-control study determined UA, common iliac (CI), and external iliac (EI) arterial blood flow in Andeans residing at 3,600-4,100 m, who were either nonpregnant (NP, n = 23), or experiencing normotensive pregnancies (NORM; n = 155), preeclampsia (PE, n = 20), or gestational hypertension (GH, n = 12). Pregnancy enlarged UA diameter to ~0.62 cm in all groups, but indices of end-arteriolar vascular resistance were higher in PE or GH than in NORM. Q(UA) was lower in early-onset (≤34 wk) PE or GH than in NORM, but was normal in late-onset (>34 wk) illness. Left Q(UA) was consistently greater than right in NORM, but the pattern reversed in PE. Although Q(CI) and Q(EI) were higher in PE and GH than NORM, the fraction of Q(CI) distributed to the UA was reduced 2- to 3-fold. Women with early-onset PE delivered preterm, and 43% had stillborn small for gestational age (SGA) babies. Those with GH and late-onset PE delivered at term but had higher frequencies of SGA babies (GH=50%, PE=46% vs. NORM=15%, both P < 0.01). Birth weight was strongly associated with reduced Q(UA) (R(2) = 0.80, P < 0.01), as were disease severity and adverse fetal outcomes. We concluded that high end-arteriolar resistance, not smaller UA diameter, limited Q(UA) and restricted fetal growth in PE and GH. These are, to our knowledge, the first quantitative measurements of Q(UA) and pelvic blood flow in early- vs. late-onset PE in high-altitude residents.
Authors:
Vaughn A Browne; Lilian Toledo-Jaldin; R Daniela Davila; Luis P Lopez; Henry Yamashiro; Darleen Cioffi-Ragan; Colleen G Julian; Megan J Wilson; Abigail W Bigham; Mark D Shriver; Benjamin Honigman; Enrique Vargas; Robert Roach; Lorna G Moore
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-02-16
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  300     ISSN:  1522-1490     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-04     Completed Date:  2011-06-30     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  R1221-9     Citation Subset:  IM    
Affiliation:
Altitude Research Center, University of Colorado-Denver, 12469 East 17th Place, Aurora, CO 80045, USA. Vaughn.Browne@UCDenver.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Altitude*
Analysis of Variance
Blood Flow Velocity
Bolivia
Case-Control Studies
Cross-Sectional Studies
Female
Fetal Growth Retardation / etiology*,  physiopathology
Gestational Age
Humans
Hypertension, Pregnancy-Induced / physiopathology*,  ultrasonography
Iliac Artery / physiopathology
Laser-Doppler Flowmetry
Live Birth
Pre-Eclampsia / physiopathology*,  ultrasonography
Pregnancy
Premature Birth
Regional Blood Flow
Stillbirth
Ultrasonography, Doppler
Ultrasonography, Prenatal
Uterine Artery / physiopathology*,  ultrasonography
Vascular Resistance*
Young Adult
Grant Support
ID/Acronym/Agency:
HL079647/HL/NHLBI NIH HHS; HL079647-S1/HL/NHLBI NIH HHS
Comments/Corrections

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