17 Ophthalmic artery dopplervelocimetry and pregnancy outcomes in preeclampsia

Abstract

Objective To evaluate the association of a Dopplervelocimetric measure of the maternal ophthalmic artery – mesodiastolic/systolic velocity peak ratio (PR) – with adverse pregnancy outcomes in preeclamptic pregnancies Methods Prospective cohort of 58 preeclamptic women submitted to Doppler measures of ophthalmic artery (OA), performed by the same examiner, using a linear transducer with color Doppler applied on the region medial to the optic nerve. The PR results were classified as normal (PR ⩾ 0.99). Assistant physicians were blinded to OA Doppler results. The two primary outcomes were (1) a composite of adverse maternal conditions – central nervous injury, as eclampsia or posterior reversible encephalopathy syndrome, HeLLP syndrome; hypertensive crisis; maternal admission at intensive care unit or maternal death – and (2) a composite of adverse perinatal results – birthweight 2500g; preterm birth Results The higher the PR levels, the more incident were maternal adverse outcome (p = 0.004) as a composite, and hypertensive crisis after hospital admission (p = 0.004) as a secondary end-point. Perinatal adverse outcome were not associated with PR (p = 0.73), but in the highly abnormal PR group ( ⩾ 0.99), babies were born earlier (p = 0.008) and weighing less (p = 0.013). All women in the highly abnormal PR group had an adverse outcome. Conclusions Mesodiastolic/systolic velocity peak ratio of maternal OA ⩾ 0.99 in preeclampsia could identify women at the highest risk of an adverse outcome and the pregnancies with the most preterm delivery.