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Departments of 1 Cardiology and 2 Obstetrics and Gynecology, Skejby University Hospital, DK-8200 Aarhus, Denmark
Normal pregnancy
is characterized by reduced systemic vascular resistance, which may be
mediated by nitric oxide (NO). We compared endothelial vasomotor
function in 71 normal pregnant women (13 in first, 29 in middle, and 29 in last trimester) to 37 healthy age-matched controls. With external
ultrasound, brachial artery diameter was measured at rest, during
reactive hyperemia [with increased flow causing
endothelium-dependent dilation (FMD)], and after sublingual
nitroglycerin (causing endothelium-independent dilation). Compared with
controls, resting flow and brachial artery diameter were significantly
higher during the middle and last trimesters. Reactive hyperemia was
reduced in all pregnant groups. FMD increased from the first trimester
(by 26%), reaching the highest value in the last trimester (to 47%
above nonpregnant values). FMD was significantly correlated to
pregnancy status (nonpregnant or pregnant) and to vessel size.
Nitroglycerin-induced dilation was similar in pregnant and nonpregnant
women. A longitudinal study of eight women evaluated in the first,
middle, and last trimesters confirmed an increase in FMD throughout
pregnancy. The study supports the idea that basal and stimulated NO
activity is enhanced in normal pregnancy and may contribute to the
decrease in peripheral resistance.
women; ultrasound
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