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Mandić Vesna; Miković` Željko; Đukić Milan; Vasiljević Mladenko; Filimonović Dejan; Bogavac Mirjana (2005)
Publisher: Serbian Medical Society, Society of Physicians of Vojvodina, Novi Sad
Journal: Medicinski Pregled
Languages: Serbian
Types: Article
Subjects: cerebrovascular circulation: Pregnancy, ultrasonography, R5-920, Medicine, preeclampsia, DOAJ:Medicine (General), DOAJ:Health Sciences, R, Medicine (General), Doppler

Classified by OpenAIRE into

mesheuropmc: reproductive and urinary physiology, female genital diseases and pregnancy complications, embryonic structures
Introduction Systemic vasoconstrktion in preeclamptic patients increases vascular resistance, and is manifested by increased arterial blood flow velocity. The aim of the study is to evaluate if there is a change of Doppler indices in maternal medial cerbral artery (MCA) in severe preeclampsia due to: 1) severity of clinical symptoms, 2) the beginning of eclamptic attack and 3) the application of anticonvidsive therapy. Material and methods A prospective clinical study included 92 pregnant women, gestational age 28-36 weeks. They were divided into three groups: normotensive (n=30), mild preeclampsia (n=33), and severe preeclampsia (n=29). We investigated maternal cerebral circulation by assessing the MCA. We registrated: pulsatility index (Pi), resistance index (Ri), Systolic/diastolic ratio (S/D), and the maximum systolic, end diastolic and medium velocity. Patients with severe preeclampsia were divided into two subgroups: subgroup 1 included patients without symptoms of threatening eclampsia (n=18; 62.06%); while subgroup 2 included those with symptoms of preeclampsia (n=11; 37.94%). All patients with severe preeclampsia were treated with magnesium sulfate (MgSO4), and cerebral blood flow was measured before and after the treatment. Statistical analysis was done by oneway ANOVA, Student t-test and t-paired sample test. The difference was considered to be significant if p < 0.05. Results Significantly increased Pi, Ri and all velocities were established in the group of patients with severe preeclampsia compared with the other two groups. In the group with severe preeclamsia we registrated significantly increased values of all velocities (patients with signs of threatening eclampsia). After MgSO4 treatment in patients with severe preeclampsia significantly decreased values of Pi, Ri, S/D ratio and all velocities were registered. Discussion In the studied group of patients with severe preclampsia we found increased velocity values, Pi and Ri, especially in patients with signs of threatened eclampsia, suggesting that blood vessels changes are most prominent in severe preeclampsia. Cerebral blood flow measurements can be used as a clinical test for the prediction of eclampsia. Magnesium-sulfate (MgSO4) has a significant role in prophylaxis and treatment of eclampsia, and, therefore, positive influence on reduction of cerebral ishemic lesions can be expected. Conclusion We can conclude that changes of the cerebral blood flow can be evaluated by evaluating blood flow velocities in the medial cerebral artery. Velocities tend to increase in severe preeclampsia, especially with signs of threatening eclampsia, and decrease after treatment with magnesium sulfate. Serial measurements of blood flow in medial cerebral artery in patients with severe preeclampsia may be used in prediction of eclampsia and in evaluation of magnesium sulfate therapy effects.
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