Maternal ophthalmic artery Doppler ultrasonography in preeclampsia and pregnancy outcomes

• Published in: Pregnancy hypertension Vol. 10; pp. 242 - 246
• Main Authors: Chaves, Maria Teresa Pedrazzi, Martins-Costa, Sérgio, Oppermann, Maria Lúcia da Rocha, Dias, Ricardo Palma, Magno, Valentino, Peña, Julio Alejandro, Ramos, José Geraldo Lopes
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2017
• Subjects: Adult; Blood Flow Velocity; Brazil - epidemiology; Cohort Studies; Doppler ultrasonography; Eye - blood supply; Female; Humans; Hypertensive pregnancy; Ophthalmic Artery - physiology; Ophthalmic artery Doppler measurements; Pre-Eclampsia - epidemiology; Pre-Eclampsia - physiopathology; Preeclampsia; Pregnancy; Pregnancy Outcome; Prospective Studies; Sensitivity and Specificity; Ultrasonography, Prenatal; Ophthalmic artery Doppler measurements; Doppler ultrasonography; Hypertensive pregnancy; Preeclampsia
• ISSN: 2210-7789; 2210-7797
• DOI: 10.1016/j.preghy.2017.10.006

•Maternal ophthalmic artery Doppler ratio in preeclampsia predicted maternal outcomes.•Adverse maternal outcomes became more frequent as the PR values increased.•Adverse perinatal outcomes were not associated with PR values.•Women in highly abnormal PR group had earlier deliveries and lower birthweight babies. To examine the association of ophthalmic artery (OA) Doppler measure – the ratio of velocity peaks (PR) – to adverse pregnancy outcomes in preeclampsia. Prospective cohort study of 56 women with preeclampsia that underwent Doppler measurements of OA flow, medial to optic nerve. PR results were classified as normal (PR < 0.78), abnormal (PR 0.78–0.98), or highly abnormal (PR ≥ 0.99). Attending clinicians were blinded to OA Doppler results. The primary endpoints were (1) a composite of adverse maternal outcomes—central nervous system injury (eclampsia or posterior reversible encephalopathy syndrome), HELLP syndrome, hypertensive crisis, maternal admission to the intensive care unit, and maternal death—and (2) a composite of adverse perinatal outcomes—birth weight <10th percentile for gestational age, neonatal acidemia, 5-min Apgar score <7, admission of infants weighing >2500 g to the neonatal intensive care, preterm birth <32 weeks, fetal or neonatal death. Adverse maternal outcomes became more frequent as the PR values increased (p=.005). The occurrence of hypertensive crisis after hospital admission (secondary endpoint) was also positively associated with PR values (p=.001). Adverse perinatal outcomes were not associated with PR values (p=.551), but women in the highly abnormal PR group (PR ≥ 0.99) had the earliest deliveries (p=.001) and the smallest newborns (p=.004). All women in the highly abnormal PR group (n=16) had an adverse outcome. Maternal OA Doppler PR ≥ 0.99 in preeclampsia may identify women at increased risk of adverse maternal outcomes and pregnancies at the greatest risk of preterm birth.