{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:37:37Z","timestamp":1787495857174,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,11,5]],"date-time":"2017-11-05T00:00:00Z","timestamp":1509840000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2017,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To assess endothelial function and arterial stiffness in women with a previous pregnancy complicated by pre\u2010eclampsia (PE) with hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome, and to compare these findings to those in women with previous PE but no HELLP and to those in controls with previous uncomplicated pregnancy, in order to investigate the influence of HELLP syndrome on subsequent cardiovascular impairment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this prospective single\u2010center case\u2013control study, we performed peripheral arterial tonometry (PAT) (using the EndoPAT method) and pulse\u2010wave velocity (PWV) assessment in 109 women who had had a singleton pregnancy complicated by PE with (\n n<\/jats:italic>\n \u2009=\u200949) or without (\n n<\/jats:italic>\n \u2009=\u200960) HELLP syndrome, as well as in 60 controls with previous uncomplicated pregnancy, between 6\u2009months and 4\u2009years after delivery. The following EndoPAT and PWV indices were compared between groups: reactive hyperemia index (RHI), as an indication of endothelial function, and peripheral and aortic heart\u2010rate\u2010corrected augmentation indices (AIx) standardized for a heart rate of 75\u2009bpm (AIx@75) and carotid\u2013femoral pulse\u2010wave velocity (cfPWV), as indications of arterial stiffness.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PAT and arterial stiffness indices were significantly different between PE cases, with or without previous HELLP, and controls, except for carotid\u2013femoral PWV. There were no significant differences among PE groups: women who had experienced HELLP and those with a history of PE without HELLP showed similar rates of RHI\u2009\u2264\u20091.67 (28.6%\n vs<\/jats:italic>\n 18.3%,\n P<\/jats:italic>\n \u2009=\u20090.254) and RHI\u2009\u2264\u20092.00 (61.2%\n vs<\/jats:italic>\n 41.7%,\n P<\/jats:italic>\n \u2009=\u20090.055), peripheral AIx@75\u2009\u2265\u200917% (38.8%\n vs<\/jats:italic>\n 30.0%,\n P<\/jats:italic>\n \u2009=\u20090.417), aortic AIx@75\u2009\u2265\u200935% (29.2%\n vs<\/jats:italic>\n 20.0%,\n P<\/jats:italic>\n \u2009=\u20090.461) and cfPWV \u00d7 0.8\u2009>\u20099.6\u2009m\/s, which occurred in only three women, all in the group without previous HELLP (0% vs 5.0%,\n P<\/jats:italic>\n \u2009=\u20090.251). On multivariate regression analysis, HELLP syndrome, intrauterine growth restriction (IUGR) and early\u2010onset PE independently predicted endothelial dysfunction at 6\u2009months to 4\u2009years postpartum, after correcting for uterine artery pulsatility index, birth\u2010weight percentile, and maternal blood pressure, age and body mass index. Women with both previous HELLP and early\u2010onset IUGR had a significantly higher prevalence of endothelial dysfunction (\n P<\/jats:italic>\n \u2009=\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Similar vascular abnormalities were found in women previously affected by HELLP syndrome and those with previous PE without HELLP. However, a history of HELLP syndrome, IUGR and early\u2010onset PE seems to identify a subgroup of women with a higher risk for future development of endothelial dysfunction. Copyright \u00a9 2016 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.17394","type":"journal-article","created":{"date-parts":[[2016,12,22]],"date-time":"2016-12-22T08:25:32Z","timestamp":1482395132000},"page":"596-602","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Maternal endothelial function and vascular stiffness after HELLP syndrome: a case\u2013control study"],"prefix":"10.1002","volume":"50","author":[{"given":"R.","family":"Orabona","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sciatti","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia Brescia 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