Objectives To study placental patterns in pregnancies complicated by pre-eclampsia (PE) and to verify whether the findings are related to gestational age (GA) at PE onset and second-trimester uterine artery (UtA) Doppler. Methods For all pre-eclamptic women who delivered between January 2010 and December 2013, we collected retrospectively data related to placental findings and UtA Doppler velocimetry performed at PE onset. The study cohort was divided into groups according to early-onset (EO) or late-onset (LO) PE. Regression analysis was performed to test the ability of UtA Doppler velocimetry to predict subsequent development of placental lesions, after correcting for possible confounders. Results Placental abnormalities occurred with a significantly lower incidence in the LO-PE group (n = 72) than in the EO-PE group (n = 105) (P = 0.02). Irrespective of GA at PE onset, UtA pulsatility index (PI) was able to predict macroscopic infarctions (P = 0.001), distal villous hypoplasia (P = 0.03), decidual arteriolopathy (P = 0.03), villous infarcts (P < 0.001), syncytiotrophoblast ‘knots’ (P = 0.02), microcalcifications (P = 0.02), perivillous fibrin deposition (P = 0.02) and placental hemorrhage (P = 0.01). Conclusions Similar placental abnormalities were present in both EO-PE and LO-PE groups, although with quantitative differences according to GA and UtA Doppler velocimetry at PE onset. Histological patterns were predicted by UtA-PI, independently of GA, supporting the use of UtA Doppler velocimetry as the key criterion in PE classification. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Objectives: To evaluate the elastic properties of the ascending aorta in women with a previous pregnancy complicated by early‐onset (EO) or late‐onset (LO) pre‐eclampsia (PE) and the correlation with gestational age (GA), systolic/diastolic blood pressure (SBP/DBP) and mean uterine artery pulsatility index (UtA‐PI) at diagnosis of the disease as well as with birth weight of the neonate.Methods: Thirty women who had a previous pregnancy complicated by EO‐PE, 30 with a previous pregnancy complicated by LO‐PE and 30 normal controls were selected retrospectively from our electronic database and then recalled for assessment from 6 months to 4 years after delivery. Data regarding GA, SBP/DBP and mean UtA‐PI at the diagnosis of PE were obtained from medical records. At our assessment, aortic M‐mode and tissue Doppler imaging (TDI) parameters were measured. Aortic diameters were assessed at end‐diastole at four levels: Valsalva sinuses, sinotubular junction, tubular tract and aortic arch. Aortic compliance, distensibility, stiffness index (SI), Peterson's elastic modulus (EM), pulse‐wave velocity and M‐mode strain were calculated using standard formulae. Aortic expansion velocity, early and late diastolic retraction velocities and peak systolic tissue strain (TDI‐ϵ) were determined.Results: Aortic diameters at the four levels were significantly greater in both EO‐PE and LO‐PE groups than in controls. Aortic compliance and distensibility and TDI‐ϵ were lower in EO‐PE than in LO‐PE (P  = 0.001, P  = 0.002 and P  = 0.011, respectively) and controls (P  = 0.037, P  = 0.044 and P  = 0.013, respectively). SI and EM were higher in EO‐PE than in LO‐PE (P = 0.001 and P < 0.001, respectively) and than in controls (P = 0.035 and P  = 0.036, respectively). Multivariate analysis showed GA, DBP and UtA‐PI at diagnosis of PE to be independent predictors of aortic elastic properties.Conclusions: Elastic properties of the ascending aorta were altered in women with a previous pregnancy complicated by EO‐PE, but not in those with LO‐PE. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.