Objectives: Arterial stiffness is increased in women with preeclampsia. Assessment of spiral artery transformation and successful placentation by uterine artery Doppler pulsatility index (UtAD PI) is a widely used screening tool for early-onset preeclampsia. We sought to determine whether there was a relationship between uterine artery Doppler impedance and aortic stiffness and arterial wave reflection.

Methods: 92 women were recruited from the high risk obstetric clinic in the second trimester. Median age: 32.8years (Range 19–45years), median gestation: 23⁺⁶weeks (Range: 19⁺⁶–26⁺¹weeks). Smokers were excluded. Transabdominal uterine artery Doppler measurements were performed bilaterally using Siemens Acuson S2000 ultrasound machine and mean pulsatility index calculated. cfPWV and pulse wave analysis were performed using Vicorder and SphygmoCor respectively. Prior to cardiovascular measurements, women were rested supine for 10 minutes in 30° left lateral position. Three consistent readings were performed and a mean value calculated. cfPWV was adjusted for mean arterial pressure and augmentation index (AIx) adjusted for heart rate and height using SPSS v18.0.

Results: There was a significant positive association between uterine artery Doppler pulsatility index and increasing cfPWV (r=0.23, P=0.03) (Fig.1) and AIx (r=0.36, P=0.0005) (Fig.2).

Conclusions: Increasing UtAD PI reflects impaired placentation and increasing risk of preeclampsia. We show that women at increasing risk of preeclampsia have higher aortic stiffness and arterial wave reflection, even in the absence of preeclampsia. Further studies are required to determine whether this is a reflection of abnormal pregnancy on arterial stiffness, or whether the increased arterial stiffness precedes pregnancy.