THE EFFECT OF ACUTE VOLUME EXPANSION AND VASODILATATION WITH VERAPAMIL ON UTERINE AND UMBILICAL ARTERY DOPPLER INDEXES IN SEVERE PREECLAMPSIA

Preeclampsia is associated with increased peripheral, uterine, and umb ilical artery resistance. Acute blood pressure reduction may result in shunting of blood and sudden fetal distress. We therefore investigate d the effects of volume expansion and verapamil therapy on uteroplacen tal and umbilical resistance during treatment of preeclampsia. Materia ls and Methods: Five severe preeclamptics underwent volume expansion a nd subsequent vasodilatation with an infusion of verapamil. Invasive h emodynamic monitoring and Doppler ultrasonography were used to study c hanges in maternal, uterine, and umbilical hemodynamics. Results: Volu me expansion and subsequent verapamil therapy was associated with sign ificant changes in maternal hemodynamics without significant change in uteroplacental or umbilical resistance. Uterine artery waveform chang es were noted, with disappearance of notching in some cases. Conclusio ns: Volume expansion and verapamil therapy effectively reduces materna l blood pressure in preeclampsia, without adversely affecting uteropla cental or umbilical artery resistance. Uterine artery waveform changes may be associated with improved fetal outcome. (C) 1994 John Wiley & Sons, Inc.