Abstract: [TH-PO799] The Effects of Pregnancy, Pregnancy-Associated Hypertension and Gestational Diabetes on the Microvasculature

Thao Vi Luong, Alexander James Teare, MbChB, Tien Y. Wong, MD, PhD, Ryo Kawasaki, MD, PhD, Judith A. Savige, MD, PhD. University of Melbourne, Northern Hospital; Centre for Eye Research, Australia; Singapore Eye Institute, National University of Singapore, Singapore; Department of Ophthalmology and Visual Science, Yamagata University, Japan.

Background: The small vessels of the retina resemble placental vessels in size. This study evaluated the effect of pregnancy, pregnancy-associated hypertension and gestational diabetes on the microvasculature using retinal vessels as a model. Methods: One hundred and 36 normal pregnant women, 23 with pregnancy-associated hypertension, and 44 with gestational diabetes provided clinical details and underwent retinal photography using a non-mydriatic camera (KOWA or CANON). Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarised as the central retinal artery and vein equivalents. Results: Arteriolar calibre did not change in normal pregnancies between the first trimester and immediately postnatally (138.8 ± 10.3 um, n=29, versus 140.3 ± 12.5 um, n=31 respectively, p=0.62), but was reduced in the third trimester in patients with pregnancy-associated hypertension alone (130.4 ± 6.5 um, n=9 versus 140.3 ± 12.5 um in normals, n=31, p=0.029), and in patients with pregnancy-associated hypertension plus diabetes (127.4 ± 14.7 um, n=6, p=0.031).
Venular calibre increased progressively in normal pregnancies between the first trimester and immediately postnatally (204.9 ± 19.5 um, n=29, versus 218.6 ± 22.0 um, n =33, p=0.012). In diabetic pregnancies, the venular calibre was normal in the first trimester (199.6 ± 10.9 um, n=3, versus 204.9 ± 19.5 um, n=29, p=0.65), but there was a trend to smaller vessels by the third trimester (201.7 ±15.7 um, n=26, versus 211.1 ± 20.4 um, n=31, p=0.06). Conclusions: Systemic arterioles are narrowed in patients with pregnancy-associated hypertension alone or together with diabetes. Venules normally dilate throughout pregnancy but the dilatation is less in diabetics. The retinal vasculature represents a model to investigate the effect of treatments that improve placental blood flow in pregnancy-associated hypertension and gestational diabetes.

Course: Annual Meeting: Abstract Sessions
Session: Hypertension: Clinical
Date/Time: Thursday, November 10, 2011 10:00 AM - 12:00 PM
Room: Exhibit Hall B

Individual author disclosures are available in the Kidney Week 2011 Disclosure Digest which is available to each meeting participant or upon request in November.


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