CEREBRAL HEMODYNAMICS IN PREECLAMPSIA AND ECLAMPSIA

Objective: To test further the hypothesis that preeclampsia and eclamp sia are associated with cerebral vasospasm. Design: Prospective case s tudy. Setting: Inpatient obstetrics service of an urban public hospita l. Patients and Methods: Eleven women with eclampsia (mean gestational age, 32 weeks), preeclampsia (mean gestational age, 36 weeks), or nor motensive pregnancy (mean gestational age, 35 weeks). Middle cerebral artery (MCA) velocity was measured bilaterally in all patients by mean s 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 wome n, 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 veloci ties in eclamptic, but not preeclamptic, women compared with those in normotensive pregnant women suggests that moderate to severe vasospasm is associated with eclampsia.