This study focuses on women with both pre-eclampsia and Human Immunodeficiency Virus (HIV). Pre-eclampsia is a pregnancy-specific syndrome that occurs after 20 weeks gestation. Thrombocytopenia is the most common haematological abnormality in pre-eclampsia. Further, studies suggest that the immunological mechanism plays some role in the aetiology of pre-eclampsia. The immunological hallmark of HIV infection is a progressive decline in the number of CD4 T lymphocytes and significant haematological abnormalities are also common in HIV-infected individuals i.e. anaemia, thrombocytopenia and leukopenia. The study population comprised of two groups i.e., pre-eclamptic HIV-positive African women and preeclamptic HIV-negative African women as the control group. Samples were analysed for haematological parameters (full blood count) and immunological markers (flow cytometry). There was no statistical significance in the following parameters: RBC, Hb, haematocrit, MCV, MCH, MCHC, platelets, MPV, WBC, lymphocytes, neutrophils, eosinophils, monocytes, basophils and CD8. There was a statistical difference in the CD3 and CD4 counts between both the groups. However, the CD3 and CD4 counts were within the normal range in the HIV-negative pre-eclamptic group and even though CD3 decreased, it was still within the normal range in the HIV-positive pre-eclamptic group, with CD4 decreasing below the normal range in the HIV-positive pre-eclamptic group. This suggests that immune mechanisms involving CD estimations do not play a role in pre-eclampsia since the decrease in the counts can be solely attributed to HIV infection. Results obtained in this study do not show any severe haematological or immunological abnormalities when women have both pre-eclampsia and HIV infection. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2007.

In pregnancy, the maternal cardiovascular and placental circulation undergoes structural and functional changes to accommodate the growing fetus, but the mechanisms involved are not fully understood. Nitric oxide (NO) increases in normal pregnancy and lack of NO has been implicated in pregnancy related complications, preeclampsia and fetal growth restriction. Thus, the objective of the thesis was to determine if cardiovascular, uteroplacental and fetoplacental changes observed in human pregnancy also occur in mice and to assess the obligatory role of eNOS in mediating these changes. I showed that like humans, mice exhibit increases in maternal cardiac output, stroke volume, plasma volume, and uterine arterial blood flow, and a transient decrease in arterial pressure during pregnancy. Importantly, I showed that endothelial nitric oxide synthase (eNOS) plays an important role in promoting the progressive increase in maternal cardiac chamber dimensions and output and the enlargement of the aorta during pregnancy in mice. Another novel finding was that eNOS plays an important role in remodeling of the uterine and umbilical vasculatures during pregnancy. The remodeling of the uterine vasculatures, including the uterine and spiral arteries, were blunted in the eNOS KO mice with ko fetuses (KO(ko)) and this likely contributed to elevated vascular resistance and reduced perfusion of the uterine circulation during pregnancy. Impaired spiral artery remodeling may be caused by a deficiency in decidual uterine natural killer cells. Fetal placental vascularization was also impaired in eNOS KO(ko) mice, which likely increased vascular resistance and thereby reduced fetoplacental perfusion. Reduced vascularization may be due to decreased VEGF mRNA and protein expression in KO(ko) placentas. Decreased perfusion in both the uterine and umbilical circulations most likely contributed to elevated placental and fetal hypoxia in the eNOS KO(ko) mice. Interestingly, despite placental hypoxia, eNOS KO(ko) mice do not show the classical signs of preeclampsia including hypertension and proteinuria nor are maternal plasma sFlt1 levels elevated. Nevertheless, eNOS KO(ko) pups are growth restricted at term, and this is mainly due to the fetal genotype. These findings suggest that eNOS plays an essential role during pregnancy in remodeling of the maternal heart, aorta, and uterine and umbilical vasculatures thereby augmenting blood flow to the maternal and fetal sides of the placenta and thereby promoting fetal growth in mice.

Normal physiological functioning is highly dependent of calcium and the concentration range is very narrow. Normal calcium levels are so crucial to survival that the body will de-mineralize bone if the levels are insufficient. A prerequisite for normal calcium uptake is a normal Vitamin D level. Insufficient levels of Vitamin D are associated to several diseases. The aims of this thesis were to study the relationship between pregnancies and hyperparathyroidism (pHPT) (I), between pHPT and pregnancy with preeclampsia (II) and also to determine if disturbances in calcium homeostasis with vitamin D deficiency are apparent in preeclamptic women (III).  The aim was also to study calciumhomeostasis in obese patients before and after bariatric surgery (IV and V) with emphasis on vitamin D status, parathyroid secretion and bone mineral density (BMD). A correlation was found between a history of pHPT and pregnancy with preeclampsia, with an odds ratio of 6,89 ( 95% CI 2.30, 20.58).  Parathyroid hormone was significantly raised in preeclamptic pregnancies but vitamin D deficiency was present both in preeclamptic and healthy pregnancies. A certain polymorphism of the Vitamin D receptor (baT haplotype), overrepresented in pHPT, was not over expressed in preeclampsia. Hypovitaminosis D was present in more than 70% of bariatric patients preoperatively, which did not change after surgery, despite great weight loss and start of Vitamin D supplementation. BMD was significantly lower in bariatric patients with a negative correlation to the time elapsed since surgery. A small increase in BMD could be noted 10-13 years after bariatric surgery, possibly due to gradual weight gain. CiCa-clamping in obese patients demonstrated a disturbed calcium homeostasis with a left-shifted calcium-PTH relationship and a lower set-point of calcium. This disturbance persisted one year postoperatively. In conclusion, derangements in calcium homeostasis with decreased levels of Vitamin D are present in preeclampsia and obesity. A history of pHPT should be viewed as a risk factor for preeclampsia. Life long follow-up is necessary after bariatric surgery, and an individually adjusted high dose Vitamin D substitute is probably needed to avoid a development of osteoporosis.

Thesis (Ph.D.)--Mississippi State University. Department of Food Science, Nutrition and Health Promotion. / Title from title screen. Includes bibliographical references.

Thesis (MSc(Genetics))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The hypertensive conditions of pregnancy (including pre-eclampsia (PE)) is the leading cause of primary obstetric death in South Africa and affects at least five percent of pregnancies in the Western Cape province. Reduced levels of placental protein 13 (PP13) early in pregnancy are associated with a higher incidence of PE in later gestation. PP13 and annexin II have been co-localised to the brush border membrane of syncytiotrophoblasts, and form a complex that is transported to the maternal circulation. It is speculated that genetic variation in the gene encoding annexin II (ANXA2) could underlie the reduced PP13 levels. The aim of this study was to screen the ANXA2 gene, including the proximal promoter region, in two South African population groups, (Mixed Ancestry and Black) from the Western Cape, to identify whether variants in the ANXA2 gene confer susceptibility to PE. The study cohort comprised of 120 pre-eclamptic maternal, 94 pre-eclamptic fetal and 54 healthy control individuals. Genomic DNA of patient and control individuals was extracted for PCR amplification of ANXA2 and Multiphor SSCP/HD analysis was performed for mutation detection. The conformational variants identified were subjected to automated DNA sequencing and subsequently to RFLP analysis, to confirm the genotypes in the remainder of the cohort. Nine previously identified variants (c.-31 T>C, c.292 G>T; p.Val98Leu, c.975 C>T;p.Gly325Gly, c.-12+75 C>A, c.-11-43 G>A, c.-11-13 A>T, c.48+67 C>T, c.449-17 G>A, c.683-56 G>A) and 16 novel variants (c.-442 C>G, c.-191 G>C, c.-189_-188insGCCGG, c.-135 C>G, c.-92 A>T, c.222 C>T; p.Ala74Ala, c.600 C>T; p.Asp110Asp, c.934 G>A; p.Gly312Ser, c.244-42 G>C, c.244-76 C>G, c.528+38 C>T, c.589-5 C>T, c.682+49 C>T, c.961-30 A>G, c.961-24 C>G, c.*1057 A>G) were identified upon screening the ANXA2 gene. Statistical analysis identified significant association at five loci: SNP c.-92 A>T located within the ANXA2 5‟UTR, exonic SNP c.222 C>T; p.Ala74Ala and three intronic SNPs c.244-76 C>G, c.449-17 G>A and c.589-5 C>T. Three of the five variants (c.-92 A>T, c.244-76 C>G, c.589-5 C>T) were significantly associated with PE (P<0.05) and could contribute to PE susceptibility in these two SA iv populations, whereas the other two variants (c.222 C>T; p.Ala74Ala, c.449-17 G>A) revealed a possible protective effect, suggesting a reduced risk of developing PE. In silico analysis predicted the disruption and creation of several putative transcription factor binding sites by three SNPs in the ANXA2 gene, which could subsequently affect ANXA2 functioning. This study provides evidence for genetic variation in the ANXA2 gene, which warrants functional experimental validation in an attempt to investigate the function of these SNPs in molecular, cellular and physiological processes underlying PE. Identifying an association between variants in the ANXA2 gene and PE could contribute to the development of an additional early biomarker. The early identification of PE would promote the South African health system by providing the appropriate health care support and monitoring of high risk pregnancies, which could ultimately result in improved pregnancy outcome. / AFRIKAANSE OPSOMMING: Die hipertensiewe siektes van swangerskap (insluitende pre-eklampsie (PE)) is die belangrikste direkte oorsaak van moedersterftes in Suid-Afrika en dit kom voor by ongeveer 5% van swangerskape in die Wes-Kaap provinsie. Verlaagde plasentale proteïen 13 (PP13) vlakke tydens vroeë swangerskap word verbind met „n hoër voorkoms van PE in latere swangerskap. PP13 en anneksin II kom albei op die borselgrens membraan van synsitiotrofoblaste voor waar hulle „n kompleks vorm wat na die moederlike sirkulasie vervoer word. Daar word gespekuleer dat die onderliggende oorsaak vir laer PP13 vlakke as gevolg van genetiese variasie in die geen wat anneksin II kodeer (ANXA2) kan wees. Die doel van hierdie studie was om die ANXA2 geen, insluitende die proksimale promoter area, in twee Suid-Afrikaanse populasie groepe, (Kleurling en Swart) van die Wes-Kaap, te skandeer met die doel om variante in die ANXA2 geen te identifiseer en ‟n moontlike assosiasie met die vatbaarheid vir PE te bepaal. Hierdie studie populasie het bestaan uit 120 pre-eklamptiese vroue, 94 neonate van pre-eklamptiese ma‟s en 54 gesonde kontrole individue. Genomiese DNS van die pasiënte en kontrole individue is geëkstraeer vir polimerase kettingreaksie amplifikasie van die ANXA2 geen, waarna Multiphor enkelstring konformasie polimorfisme heterodupleks analise uitgevoer is met die doel om DNS variante te identifiseer. Die verskillende konformasies waargeneem is onderwerp aan semi-geoutomatiseerde DNS volgorde bepalingsanalise en gevolglik restriksie fragment lengte polimorfisme analise om genotipes in die res van die studiegroep te bevestig. Vyf-en-twintig variante is geïdentifiseer met die skandering van die ANXA2 geen, waarvan nege voorheen geïdentifiseer is (c.-31 T>C, c.292 G>T; p.Val98Leu, c.975 C>T;p.Gly325Gly, c.-12+75 C>A, c.-11-43 G>A, c.-11-13 A>T, c.48+67 C>T, c.449-17 G>A, c.683-56 G>A) en 16 nuwe variante is (c.-442 C>G, c.-191 G>C, c.-189_-188insGCCGG, c.-135 C>G, c.-92 A>T, c.222 C>T; p.Ala74Ala, c.600 C>T; p.Asp110Asp, c.934 G>A; p.Gly312Ser, c.244-42 G>C, c.244-76 C>G, c.528+38 C>T, c.589-5 C>T, c.682+49 C>T, c.961-30 A>G, c.961-24 C>G, c.*1057 A>G). Statistiese analise het „n statisties beduidende assosiasie met vyf SNPs geïdentifiseer: SNP c.-92 A>T geleë in die ANXA2 5‟UTR, die koderende SNP c.222 C>T; p.Ala74Ala en drie SNPs c.244-76 C>G, c.449-17 G>A and c.589-5 C>T geleë in die nie-koderende areas. Drie van hierdie vyf SNPs (c.-92 A>T, c.244-76 C>G, c.589-5 C>T) het statisties beduidende assosiasie met PE (P<0.05) getoon en kan bedra tot die vatbaarheid vir PE in hierdie twee Suid-Afrikaanse populasies, terwyl die ander twee SNPs (c.222 C>T; p.Ala74Ala, c.449-17 G>A) „n moontlike beskermende effek gedui het, wat „n verlaagde risiko vir die ontwikkeling van PE voorstel. In silico analise het voorspel dat verskeie voorgestelde transkripsiefaktor bindingsetels onderbreek of geskep sal word in die teenwoordigheid van drie SNPs in die ANXA2 geen, wat gevolglik die funksionering van ANXA2 kan affekteer. Hierdie studie verskaf bewyse vir genetiese variasie in die ANXA2 geen, wat verdere funksionele eksperimentele ondersoeke vereis om die funksie van hierdie SNPs in molekulêre, sellulêre en fisiologiese prosesse onderliggend aan PE te bepaal. Die identifisering van ‟n assosiasie tussen variante in die ANXA2 geen en PE kan bydra tot die ontwikkeling van ‟n addisionele vroeë genetiese merker. Die vroeë identifisering van PE kan die Suid-Afrikaanse gesondheidsisteem geweldig baat deurdat die geskikte gesondheidsorg en ondersteuning asook deurgaanse monitering van hoë risiko swangerskappe verskaf sal kan word. Dit kan uiteindelik lei tot ‟n verbeterde uitkoms vir swangerskappe in Suid-Afrika.

Thesis (MSc (Genetics))--University of Stellenbosch, 2006. / Pre-eclampsia is a multisystemic disorder with an incidence of ~6-8% in non-Caucasian women in the Western Cape. Trophoblast invasion is vital for adequate anchorage of the placenta to the uterine wall as well as for the optimisation of utero-placental blood flow in uncomplicated pregnancies. This process is facilitated by the fetal trophoblast cells that digest the extracellular matrix of the uterus by secreting various molecules, including the metalloproteinases (MMP), of which MMP-9 has an increased production during the first trimester. Leptin, an autocrine regulator of MMP-9 secretion, functions via the leptin receptor to prevent over-invasion of maternal tissues. The aim of this study was to investigate the role of the leptin (ob) and leptin receptor (obR) genes in predisposition to pre-eclampsia and involved screening the genes in South African non-Caucasian cohorts and performing statistical analysis to determine whether any variants contributed to the disease profile.

Thesis (MSc (Genetics))--University of Stellenbosch, 2009. / Pre-eclampsia is one of the most common hypertensive disorders of pregnancy in South Africa. Presently, the only cure for pre-eclampsia is delivery, which brings with it, additional complications. As an alternative, clinical management of this disorder relies on timely diagnosis. The predictive biomarker, Placental Protein 13 (PP13), is currently used for the early diagnosis of pre-eclampsia, in an ELISA-based diagnostic kit, developed by Diagnostic Technologies Limited (DTL)1. A decrease in serum PP13 levels has been reported during the first trimester of pregnancy in women who later develop pre-eclampsia. The function of PP13 has not been fully elucidated and it is also not known whether the reduction in PP13 levels is a cause or an effect of the disease. The use of PP13 as a predictive biomarker for pre-eclampsia therefore warrants a comprehensive study of this peptide and the encoding gene, LGALS13. The aim of this study was firstly to characterise LGALS13 using a range of in silico tools. PP13 was found to be most homologous to the predicted protein product of a neighbouring “putative” gene, LOC148003. A gene conversion event between these two genes most likely underlies the so-called “hotspot mutation” in LGALS13. Data also demonstrates that the DelT mutation disrupts functionally and structurally important features of the gene and peptide sequences. Through the analysis of the putative promoter region of LGALS13, the presence of a Stimulatory protein-1 (Sp1) binding sequence element was predicted, which has implications for regulation of LGALS13. Secondly, the study aimed to establish a study cohort for the investigation of the effect that the LGALS13 genotype has on the expression of its mRNA and protein products. Serum, plasma and whole blood samples were collected and prepared from 316 pregnant women. Placental tissue samples were obtained from a selected group of these subjects for RNA extraction. Once the sampling on the two remaining targeted deliveries has occurred, the collection of samples will be batched and sent to DTL in Israel, for PP13 measurement. DNA was extracted from the whole blood samples obtained, and all study participants were genotyped for seven sequence variants within the LGALS13 gene using (i) Multiphor Single Stranded Conformational Polymorphism and Heteroduplex (SSCP/HD) analysis, (ii) restriction enzyme analysis and (iii) DNA sequencing. The genotype data sets will be compared with PP13 levels when they become available, and also with clinical parameters, once the deliveries have all occurred and the database is complete. This study demonstrated the power of an in silico approach to direct the focus of future experimental work. The newly established study cohort will be used for prospective studies aiming at a better understanding of the role which LGALS13 and PP13 play in the early prediction of preeclampsia.

Orientador: Iracema de Mattos Paranhos Calderon / Banca: José Carlos Peraçoli / Banca: Joelcio Francisco Abade / Banca: Nelson Lourenço Maia Filho / Banca: Nilton Hideto Takiuti / Resumo: Avaliar as possíveis associações entre os valores diretos, resistência e reactância, obtidos pela BIA, no segundo e terceiro trimestres da gestação, e a ocorrência de hipertensão arterial e RCIU e comparar, para os parâmetros com associação positiva, o desempenho preditivo dos dois métodos - BIA e Dopplervelocimetria das artérias uterinas, realizados nos mesmos períodos da gestação. Desenho do estudo: Coorte prospectiva. Local do estudo: Hospital das Clinicas da Faculdade de Medicina de Botucatu / UNESP. População: 200 gestantes acompanhadas no Ambulatório de Pré-natal. As gestantes realizaram BIA e estudo Dopplervelocimétrico das artérias uterinas entre 22 e 26 semanas e entre 30 e 34 semanas de gestação. Desfechos: Foi considerado como desfecho materno o desenvolvimento de hipertensão arterial após a 20ª semana de gestação, sendo que à presença de proteinúria igual ou superior a 300 mg em urina de 24 horas confirmou o diagnóstico de PE e os casos de hipertensão arterial isolada, livre de proteinúria, foram considerados como Hipertensão Gestacional (HG). Para o recém-nascido, considerou- Resumo 13 se a relação do peso com a idade gestacional ao nascimento. Análise estatística: Foram analisadas as associações entre a ocorrência das complicações perinatais consideradas e os valores médios de resistência e reactância, entre 22 e 24 semanas e entre 30 e 34 semanas de gestação. O índice de massa corporal (IMC) pré-gestacional foi testado como variável de confusão, por análise de covariância; a comparação entre os resultados foi realizada pelo teste de Tukey, considerando p <0,05. Gráficos de dispersão e Curvas ROC foram elaboradas para o parâmetro de impedância bioelétrica que mostrou associação mais precoce e para os índices de pulsatilidade médio das artérias uterinas, obtido pela Dopplervelocimetria, na predição... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: To evaluate the possible associations between the direct values, resistance and reactance, obtained by BIA in the second and third trimesters of pregnancy and the occurrence of arterial hypertension and IUGR and compare, for the parameters with positive association, the predictive performance by two methods  BIA and Uterine Arteries Dopplervelocimetry (pulsatility indices average), performed in the same periods of pregnancy. Study Design: Prospective cohort study. Setting: Clinic Hospital of Botucatu Medicine College. Population: 229 women followed in the Prenatal Clinic. The women underwent BIA and Uterine Arteries Dopplervelocimetry between 22 and 26 weeks and between 30 and 34 weeks of gestation. Outcomes: maternal outcomes were considered as the development of hypertension after the 20th. week of gestation, whereas the presence of proteinuria greater than or equal to 300 mg in 24 hours of urine confirmed the diagnosis of PE and the cases of hypertension alone, free of proteinuria, were considered as gestational hypertension (GH). For newborns, the ratio of weight to gestational age at birth was considered. Statistical analysis: We examined the associations between the occurrences of perinatal complications and considered the average values of resistance and reactance, between 22 and 24 weeks and between 30 and 34 weeks of gestation. Prepregnancy body mass index (BMI) was tested as a variable of confusion, by analysis of covariance, the comparison between the results was performed by Tukey test, considering p <0.05. Graphs of dispersion and ROC curves were developed for the parameter of bioelectric impedance showed early association and the average pulsatility indices of uterine arteries, obtained by Dopplervelocimetry in the prediction of complications. The areas on the curves were calculated and determined reference value for the parameters considered. These values were used... (Complete abstract click electronic access below) / Doutor

A neutropenia é um achado freqüente em recém-nascidos de mães com pré-eclampsia. Estudos avaliando a ativação leucocitária nestes recém-nascidos são escassos. No entanto, as principais citocinas pró-inflamatórias envolvidas são a IL-8 e o GRO-α. O objetivo deste estudo foi avaliar os níveis plasmáticos de IL-8 e GRO-α em recémnascidos prematuros de mães com pré-eclampsia. Metodologia: Foram incluídos recém-nascidos com idade gestacional menor de 36 semanas e peso de nascimento inferior a 2000 gramas, sendo divididos em dois grupos de acordo com a presença ou ausência de pré-eclampsia materna. Os critérios de exclusão foram: malformações congênitas, erro inato de metabolismo ou anormalidades cromossômicas, infecções do grupo STORCH, óbito na sala de parto e recém-nascidos nos quais as mães possuíam hipertensão crônica sem a presença de pré-eclampsia. Nas primeiras 48 horas de vida, no momento de coleta assistencial, uma pequena amostra adicional de sangue foi obtida para dosagem de IL-8 e GRO-α pelo método de enzimoimunoensaio. Foram usados os testes qui-quadrado, T student, Mann-Whitney, Kruskal-Wallis e regressão logística múltipla. Resultados: 119 recém-prematuros (64 sem pré-eclampsia e 55 com pré-eclampsia). Os grupos foram similares quanto ao peso de nascimento, idade gestacional, escore de Apgar no 5’minuto, sepse, doença de membrana hialina , ventilação mecânica, nutrição parenteral total, enterocolite necrosante, hemorragia periventricular. O grupo com préeclampsia apresentou mais neutropenia, foi mais PIG, parto cesariano e menos bolsa rota superior a 18 horas. Os níveis de IL-8 foram maiores no grupo sem pré-eclampsia materna [157.1 pg/ml (86.4-261.3) e 26.54 pg/ml (3.6-87.2) p<0.001 para não préeclampticos e pré-eclampticos, respectivamente]. Após análise por regressão múltipla apenas a ausência de pré-eclampsia foi associada com níveis elevados de IL-8. Conclusão: O prematuro de mãe com pré-eclampsia apresenta níveis reduzidos de IL-8, sugerindo que a ativação leucocitária possa estar prejudicada nestes recém-nascidos. / Neutropenia is frequent in newborn infants of preeclamptic mothers.Information on leukocyte activation in those newborns is scarce, but IL-8 and GRO- are the main proinflammatory cytokines involved. The aim was to study IL-8 and GRO- plasma levels in preterm newborn infants of preeclamptic mothers. Methods: Newborn infants with gestational age < 36 weeks and birth weight < 2000 grams were included and divided: non-preeclamptic and preeclamptic groups. Exclusion criteria: major congenital malformations, inborn errors of metabolism or chromosomal anomalies,STORCH infections, inborn preterm that died in the delivery room, and those whose mothers had chronic hypertension without preeclampsia. During the regular blood sample collection in the first 48 hours, a small amount was used for IL-8 and GRO- measurement by enzyme immunoassay. Chi-square, Student s t test, Mann Whitney test, Kruskal-Wallis and multiple logistic regression model were employed. Results: 119 preterm infants (64 non-preeclamptic and 55 preeclamptic). They were similar in birth weight, gestational age, Apgar scores at 5 minutes, sepsis, SDR, mechanical ventilation, TPN, NEC, intraventricular hemorrhage and death. The preeclamptic group had more neutropenia, SGA, C Section, and less rupture of membranes for > 18 hours. IL-8 was higher in the non-preeclamptic [157.1 pg/ml (86.4-261.3) e 26.54 pg/ml (3.6-87.2) p<0.001 non-preeclamptic and preeclamptic groups, respectively]. GRO-α was similar [229.5 pg/ml (116.6-321.3) and 185.5 pg/ml (63.9-306.7) p=0.236 in non-preeclamptic and preeclamptic groups, respectively]. After multiple regression analysis only absence of preeclampsia was associated with high IL-8 levels. Conclusions: Preterm newborn infants of preeclamptic mothers have a decreased plasma level of IL-8, suggesting that the leukocyte activation may be impaired in infants of preeclamptic mothers.

Objetivo - Comparar índices 3D Power Doppler (PD3D) da circulação úteroplacentária (UPC) no primeiro e segundo trimestre em pacientes que desenvolveram pré-eclâmpsia (PE) e aquelas que não fizeram e testar a hipótese de que os parâmetros da vascularização e intensidade de fluxo da placenta, tal como determinado por PD3D, são diferentes em gestações normais em comparação com pré-eclâmpsia. Método - Foi realizado um estudo observacional prospectivo usando PD3D para avaliar a perfusão da placenta em 96 gestantes que fizeram o exame ecográfico de rotina entre 11 e 14 semanas. O índice vascular (VI), o índice de fluxo (FI) e o índice de fluxo vascular (VFI) por histograma Doppler tridimensional foram calculados. Todas pacientes repetiram o exame entre 16 e 20 semanas. Após o nascimento as pacientes foram classificadas como normais ou com pré-eclâmpsia. Resultados - Os índices vasculares placentários incluindo VI, FI e VFI foram significativamente menores em placentas com PE em comparação com os controles no exame realizado no segundo trimestre (p <0,001). Não houve diferença estatística nas pacientes examinadas no primeiro trimestre. Conclusão - Nossos resultados sugerem que a avaliação de índices vasculares placentários com Power Doppler 3D no segundo trimestre tem o potencial para detectar as mulheres em risco para o desenvolvimento posterior de PE. / Objective - To compare 3D power Doppler indices (3DPD) of utero-placental circulation (UPC) in the first and second quarter in patients who developed preeclampsia and those who did not and to test the hypothesis that the parameters of vascularization and placenta flow intensity, as determined by three-dimensional ultrasound (3D) are different in normal pregnancies compared with preeclampsia. Methods - A prospective observational study using 3D power Doppler was performed to evaluate the placental perfusion in 96 pregnant women who came to do the ultrasound routine between 11 and 14 weeks. The placental vascular index (VI), flow index (FI), blood vessels and blood flow index (VFI) by three-dimensional Doppler histogram were calculated. All patients repeated the exam between 16 and 20 weeks. The outcome was scored as normal or preeclamptic. Results - The placental vascular indices including VI, FI and VFI were significantly lower in preeclamptic placentas compared with controls in the study performed in the second trimester (p <0.001). There was no statistical difference in the patients examined in the first trimester. Conclusion - Our findings suggest that 3D-Power Doppler assessment of placental vascular indices in the second trimester has the potential to detect women at risk for subsequent development of PE.