Maternal cerebral centralization of blood flow in pregnant women with specific gestational hypertension

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2015

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Objectives: To evaluate the occurrence of maternal brain centralization in pregnant womenwith specific gestational hypertension; to establish normal values of the ratio of the uter-ine artery with (mean and standard deviation) ophthalmic artery; to compare the ratio ofuterine to the ophthalmic artery with normal and abnormal groups; and to establish theReceiver Operator Curve (ROC) for diagnosis of patients with specific hypertensive diseaseof pregnancy.Methods: To achieve the proposed objectives a case–control study was carried out wherethe sample consisted of 178 pregnant patients divided into two groups. The control groupincluded pregnant 83 pregnant normotensive women; a case group included 95 patientswith clinical and laboratory diagnoses of specific gestational hypertension.Results: Patients with preeclampsia had lower values than the patients who had eclampsia.The Doppler parameters that were statistically significant were those of the ratio of uterineartery with the ophthalmic artery (AU/AO) and vice versa. A comparison between the normalcurve systole–diastole and the respective cut-off point was performed. A ROC is shown in thecut-off considering the systolic velocity, the diastolic velocity, the systole/diastole relation,and the index of resistance of the ophthalmic artery.Conclusion: The maternal centralization in high risk pregnancies was observed when specificgestational hypertension is real. The normal curve has a mean and standard deviation ofthe relative Doppler of the uterine artery to the ophthalmic artery systolic/diastolic ratiowas 0.43 ± 0.16 for normal pregnant patients. Comparing the group of patients with normalpathological group of patients there was a statistically significant difference between them considering the relation of Doppler uterine artery with ophthalmic artery. The cut-off point was more sensitive, verified by ROC, which defines maternal brain centralization in patients with specific gestational hypertension as 0.57 for the Doppler systolic/diastolic ratio of the uterine artery compared with the ophthalmic artery, with 78% sensitivity and 13% false positive.

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Artéria oftálmica, Eclâmpsia, Artéria braquial, Pré-eclâmpsia, Artéria uterina, Sonografia Doppler, Ophthalmic artery, Eclampsiaa, Brachial artery, Uterine artery, Doppler sonography, Preeclampsia

Citação

FRANCO, Glaucimeire Marquez; AMARAL, Waldemar Naves do. Maternal cerebral centralization of blood flow in pregnant women with specific gestational hypertension. Reprodução & Climatério, São Paulo, v. 30, n. 1, p. 19-24, 2015.