Comparative Ultrasound Evaluation of Carotid Intima-Media Thickness in Preeclamptic and Healthy Normotensive Pregnant Women at a Nigerian Tertiary Hospital.

Abstract

Introduction: Preeclampsia is defined as hypertension occurring after 20 weeks of gestation with associated proteinuria. It remains one of the leading causes of maternal and perinatal morbidity and mortality in developing countries. The increased risk of atherosclerosis makes affected women more prone to cardiovascular and cerebrovascular complications. Carotid intima-media thickness (CIMT), measured non-invasively by high-resolution B-mode ultrasound, offers an opportunity for early identification of women with atherosclerosis, thereby allowing preventive measures and early intervention.

Methods: A prospective comparative study conducted at the Radiology Department of the University College Hospital, Ibadan. Seventy women with preeclampsia were consecutively recruited into the study, and an equal number of normotensive pregnant women, matched by maternal and gestational age were selected between August 2022 and January 2023. Carotid Intima-Media Thickness (CIMT) was assessed by ultrasound using the technique of 'multiple carotid sites measurement'. Data analysis was performed using IBM SPSS version 23, employing descriptive statistics, Chi-square test, and Student's t-test to evaluate associations and compare CIMT values. A p-value < 0.05 was considered statistically significant.

Results: Mean CIMT values were 0.639 ± 0.152 mm and 0.663 ± 0.156 mm for women with preeclampsia, and 0.610 ± 0.131 mm and 0.618 ± 0.126 mm for normotensive pregnant women on the right and left respectively (95% CI, -0.002-0.092; p= 0.061). In preeclamptic and control groups, mean CIMT values were lower in nulliparous women compared with multiparous women. There was a positive correlation between the age of the participants and CIMT on the right (r = 0.067) and left (r = 0.150). A positive correlation was also demonstrated between blood pressure and CIMT on both sides.

Conclusion: Mean CIMT values were higher on both sides in women with preeclampsia compared with normotensive pregnant women.