Cerebral hemodynamics in preeclampsia and eclampsia
A. I. Qureshi, M. R. Frankel, J. R. Ottenlips and B. J. Stern
Department of Neurology, Emory University School of Medicine, Atlanta, Ga, USA.
OBJECTIVE: To test further the hypothesis that preeclampsia and eclampsia
are associated with cerebral vasospasm. DESIGN: Prospective case study.
SETTING: Inpatient obstetrics service of an urban public hospital. PATIENTS
AND METHODS: Eleven women with eclampsia (mean gestational age, 32 weeks),
preeclampsia (mean gestational age, 36 weeks), or normotensive pregnancy
(mean gestational age, 35 weeks). Middle cerebral artery (MCA) velocity was
measured bilaterally in all patients by means of transcranial Doppler
ultrasonography. RESULTS: Eclamptic patients (n = 3) had significantly
higher mean flow velocities and lower average pulsatility indexes than did
normotensive patients (n = 4) (average MCA-mean flow velocity, 165 vs 79
cm/s [P = .007]; average MCA pulsatility index, 0.51 vs 1.1 [P < .001]).
Compared with normotensive pregnant women, preeclamptic patients (n = 4)
had lower average pulsatility indexes (0.76, P = .003), but similar mean
flow velocities (average MCA-mean flow velocity, 82 cm/s; P = .8).
CONCLUSION: Significantly higher MCA velocities in eclamptic, but not
preeclamptic, women compared with those in normotensive pregnant women
suggests that moderate to severe vasospasm is associated with eclampsia.