Alterations in transcranial Doppler indices of pregnant women with complicated preeclampsia.

ABSTRACT

OBJECTIVES: We aimed to investigate alterations in transcranial Doppler indices (TCD) of the cerebral arteries between normotensive and preeclampsia (PE) pregnancies according to the presence of cerebral symptoms. STUDY DESIGN: This cross-sectional study included 48 PE and 20 normotensive pregnancies, respectively. Doppler indices of the anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA, respectively) were compared between the PE and normotensive group. MAIN OUTCOME MEASURES: Mean cerebral velocity (MCV), pulsatility index (PI), and resistance index (RI) were calculated using cerebral velocities. The cerebral perfusion pressure (CPP), resistance area product (RAP), and cerebral flow index (CFI) were computed using velocity and blood pressure. The PE group was subdivided according to the presence of cerebral symptoms and the TCD indices were compared between these groups. RESULTS: MCV and CFI of the PCA as well as CPP and RAP of all arteries were significantly higher, while PI and RI were significantly lower in PE group (P < 0.05). PI of the MCA had the highest sensitivity (91.7%), while PI of the PCA and RAP of the MCA had the highest specificity (95.0% each) for predicting PE-related cerebral complications. The positive likelihood ratio was highest in PI of the PCA (14.58). Among these parameters, CPP and RAP of the PCA were higher in PE patients showing cerebral symptoms than in those without symptoms. CONCLUSIONS: These results suggest that pregnant women with PE had altered TCD indices and that prominent changes, thereof, especially in the PCA, contribute to the development of cerebral symptoms.