PERSISTENT CEREBROVASCULAR CHANGES IN POSTPARTUM PREECLAMPTIC WOMEN -A DOPPLER EVALUATION

OBJECTIVE: Our goal was to evaluate the cerebral vasculature in postpa rtum normotensive and preeclamptic women. STUDY DESIGN: Nineteen previ ously preeclamptic women and 19 matched normotensive controls were stu died at 6 weeks, and 8 preeclamptic women and 28 normotensive controls were studied at 12 weeks post partum. Systolic, diastolic, and mean v elocities, as well as resistance and pulsatility indexes, of the middl e cerebral, ophthalmic, and central retinal arteries were recorded. Da ta are presented as median and range. Statistical significance was set at p < 0.05. RESULTS: There were no differences in maternal age, pari ty, heart rate, mean arterial pressure, and proteinuria between the tw o groups at 6 and 12 weeks post partum. At 6 weeks post partum the pre eclamptic group had higher ophthalmic artery diastolic velocity (9.0 c m/sec, 3.1 to 22.3, vs 5.4 cm/sec, 3.0 to 20.1; p = 0.008), ophthalmic artery mean velocity (6.0 cm/sec, 8.8 to 34.8, vs 12.5 cm/sec, 6.8 to 35.4; p = 0.03), and central retinal artery systolic velocity (10.0 c m/sec, 7.6 to 28.0: vs 8.4 cm/sec, 5.2 to 18.3; p = 0.02). The ophthal mic artery resistance index (0.72, 0.43 to 0.88, vs 0.79, 0.66 to 0.90 ; p = 0.03) and ophthalmic artery pulsatility index (1.56, 0.94 to 2.8 2, vs 2.03, 1.13 to 3.10; p = 0.04) were lower in the preeclamptic gro up. At 12 weeks post partum the preeclamptic group had elevated ophtha lmic artery mean velocity (14.5 cm/sec, 7.9 to 20.2, vs 10.9 cm/sec, 5 .5 to 15.4; p = 0.01), central retinal artery systolic velocity (11.1 cm/sec, 6.8 to 15.9, vs 8.5, 5.1 to 15.3; p = 0.02), and central retin al artery diastolic velocity (3.9 cm/sec, 1.2 to 5.2, vs 3.0, 1.4 to 5 .8; p < 0.05). CONCLUSION: In the postpartum period preeclamptic women show persistently elevated central retinal artery systolic velocity, which suggests distal vasoconstriction.