OC92: A proposal for a pharmacological treatment for hypertensive pregnancies complicated by severe fetal growth restriction (FGR) with absent end diastolic flow (AEDF) of the umbilical artery

Abstract

The differential diagnosis of hypertensive disorders in pregnancy is based in clinical, laboratorial and fundoscopic findings. The role of the ophthalmologist in the diagnosis of pre-eclampsia appears to be subjective and limited. Ophthalmic artery Doppler is an objective exam that can improve the diagnosis of hypertension in pregnancy. The study aims to analyze the ophthalmic artery Doppler indices in pregnancies with chronic hypertension and pre-eclampsia. Methods: Cross-sectional study that analysed 30 women with chronic hypertension and 44 preeclamptic women (National High Blood Pressure Education Program 2000 criteria) during the third trimester of pregnancy. Right and left eyes indices means and standard deviation were evaluated to the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), end diastolic velocity (EDV) and peak ratio (PR). Mann-Whitney test were applied to compare the two groups of hipertensive woman and p-values < 0.05 were considerd statistically significant. Results: The ophthalmic arteries Doppler averages indices in chronic hypertension and pre-eclampsia were respectively RI: 0.74 ± 0.06; 0.63 ± 0.17, PI: 1.68 ± 0.41; 1.12 ± 0.28, PSV: 34.01 ± 10.3; 38.60 ± 9.67, DVF: 9.0 ± 4.12; 14.26 ± 4.74 and PR: 0.64 ± 0.13; 0.82 ± 0.09. The Doppler indices demonstrated ophthalmic artery lower impedance in preeclamptic women compared with chronic hypertension women. All the Doppler indices were accurate in the diferential diagnosis of chronic hypertension and pre-eclampsia demonstrated by p = 0.0001 (RI, PI, EDV, PR) and p = 0.0171 (PSV). The best parameter to establish a cut of point to differentiate chronic hypertension to pre-eclampsia was 0.75 to PR index. Conclusions: The ophthalmic artery Doppler is a new parameter that can be used in the differential diagnosis and classification of hypertensive disorders in pregnancy.