TRANSCRANIAL ASSESSMENT OF MATERNAL CEREBRAL BLOOD-FLOW VELOCITY IN PATIENTS WITH PREECLAMPSIA

Background. To clarify the cerebral hemodynamics in pre-eclamptic preg nant women, we investigated the blood flow velocity of the cerebral ar teries. Methods. The mean blood flow velocity and pulsatility index (P I) of the middle cerebral artery (MCA) and internal carotid artery (IC A) in normal pregnant women (n=35) and preeclamptic patients (n=18) we re examined transcranially using pulsed-wave Doppler technique with a 2 MHz probe. In two pre-eclamptic women with post-partum visual distur bance, we examined the mean blood flow velocity and PI of the MCA and ICA every day. Results. The mean blood flow velocity of the MCA in the pre-eclamptic patients (89.7 +/- 20.5 cm/s) was significantly higher than that in the normal pregnant women (53.6 +/- 16.9 cm/s) (p < 0.05) . PI of the MCA in the former group (0.67 +/- 0.13) was significantly lower than that in the latter (0.78 +/- 0.02) (p < 0.05). There was no significant difference between these two groups in these variables of the ICA. In the two patients with visual disturbance, the mean blood flow velocity of the MCA was increased before the onset of visual dist urbance and decreased gradually following the disappearance of this sy mptom. In these patients, spasm of the MCA was confirmed by magnetic r esonance angiography. Conclusions. In pre-eclamptic patients, we found increased MCA mean velocity before the onset of visual disturbance. T ranscranial Doppler may be useful for the evaluation of cerebral hemod ynamics and the prediction of eclampsia.