Evaluation of function endotelial through dilatação flow mediated of the brachial artery in adolescents in the pós-parto

Aims : To evaluate the endothelial function by flow mediated dilation in adolescents and to observe if there is difference among those with a history of normotensive pregnancy or with pré-eclampsia ( PE ) . Methodology : A total of 99 adolescents after delivery ( this interval ranged from 2 to 11 months post partum ). It was evaluated the flow mediated dilation of brachial artery ( FMD), after resting from 5 to 10 minutes in a supine position, it was checked the blood pressure in the right arm and achieved the light measure of the brachial vessel to ultrasound. This measure was considered the baseline one. So, it was performed the compression of the arm with the sphygmomanometer about 3 to 5 minutes with a pressure that exceeded in 30 mmHg the systolic pressure. After the release of the compression, it was checked the diameter of the lumen after 30, 60, 90, 120, and 180 seconds in diastole in the same place of the basal verification . For FMD calculation, it was considered the biggest expansion in percentage. It was used a high-frequency transducer (6 to 9 MHz). The ultrasonographer did not know the result of the pregnancy at the moment of the exam. It was found retrospectively, the result of the pregnancy concerning to the absence or development of PE (mild or severe). PE was considered the appearing of arterial blood pressure greater or equal to 140 x 90 mmHg after 20 weeks of pregnancy associated with proteinuria (a cross in two checks or two crosses in only one in an isolated sample or 300 mg/day in 24-hour evaluation). The normal distribution of data was evaluated by Shapiro - Walk and Levene tests. The groups were compared through the test of Kruskal – Wallis, R- student and Mann – Whitney. It was considered p 10 % in 75 patients and ≤ 10% in just 24. Eight patients (8, 1%) presented FMD 10% em 75 pacientes e ≤ 10% em 24 delas. Oito pacientes (8,1%) apresentaram DILA < 5%. Inicialmente, a população foi dividida em três grupos: normotensa, PE leve e PE grave. Não houve diferença estatística entre os grupos quanto a idade (16,3 x 15,9 x 16,1, p = 0,615), tempo entre o parto e a avaliação (6,8 x 6,2 x 6,7, p = 0,497), IMC (22,8 x 26,1 x 24,3 Kg/m², p = 0,090) e pressão diastólica (70,3 x 73,6 x 73,4 mmHg, p = 0,181), ou DILA (16,8 x 16,5 x 11,4%, p = 0,085). A pressão sistólica foi estatisticamente diferente entre os grupos (108,8 x 117,2 x 110,8 mmHg, p = 0,005), [ a pressão arterial sistólica na PE leve foi maior do que nas normotensas (p = 0,003). Não houve diferença entre PE leve e grave (p = 0,126) e entre PE grave e normotensa (p = 0,686)]. Quando foram comparadas somente os dois grupos PE x normotensas, o IMC apresentou-se estatisticamente diferente (p = 0,031). Nos antecedentes de pré-eclâmpsia, o IMC foi maior ( 25,3 x 22,8 Kg/m² ). Conclusões: Não há diferença na presença de disfunção endotelial verificada pela dilatação fluxo mediada da artéria braquial em adolescentes com antecedentes de gestação normotensa ou pré-eclâmpsia. As pacientes com antecedentes de PE apresentaram pressão arterial sistólica e IMC mais elevados do que as pacientes com gestação previa normotens