Assessment of cerebral hemodynamics during roll over test in healthy pregnant women and those with pre-eclampsia

Objective To compare cerebral autoregulatory responses obtained during roll over tests in healthy pregnant women and those with pre-eclampsia in order to assess the middle cerebral artery velocity changes in relation to the r oll over test in normotensive and pre-eclamptic women. Participants Twenty-two healthy pregnant women and 26 with pre-eclampsia un derwent transcranial Doppler measurements of the middle cerebral artery. Methods Systolic, mean and diastolic blood flow velocities and mean arteria l blood pressures were recorded in the left lateral position and five minut es after turning to the supine position. Absolute values of mean blood flow velocities, mean arterial blood pressure values and calculated cerebral bl ood flow indices as well as cerebrovascular resistance area products were c ompared at different positions among the groups. Results Mean arterial blood pressure increased in both groups while turning from the left lateral to the supine position. In women with pre-eclampsia both mean arterial blood pressure and absolute values of mean blood flow ve locity values were higher in both positions, compared with healthy pregnant women. In both groups, changing the position resulted in a decrease of abs olute values of mean blood flow velocities. Calculated cerebral blood flow indices did not change, while cerebrovascular resistance area products incr eased significantly in the groups during roll over testing. In women with p re-eclampsia, the increase of cerebrovascular resistance area products was more pronounced as compared with healthy pregnant women. Conclusions In women with pre-eclampsia roll over test results in an increa se of the mean arterial blood pressure, which is accompanied by a decreased mean blood flow velocity in the middle cerebral artery. Further studies ar e needed to clarify the pathophysiological background of cerebral haemodyna mic changes in preeclampsia.