MATERNAL CEREBRAL-CIRCULATION IN NORMAL AND ABNORMAL PREGNANCIES

Background Abnormal pregnancies are usually associated with an impairm ent of maternal cerebral circulation which is mainly a consequence of generalized vasospasm and cerebral edema, The pathogenesis of vasospas m has still been a matter of controversy. The aim of this study was to evaluate maternal cerebral blood flow velocity (CBFV) changes in norm al and abnormal pregnancies, and to correlate CBFV findings with the s everity of symptoms in abnormal pregnancies, Methods. A group of 40 gr avidas (aged between 25 and 32 years) with pre-eclampsia were analyzed by Transcranial Doppler (TCD), Color Doppler Flow Imaging of carotid arteries and Transcranial Color Coded System once a week, starting Fro m 32nd week of pregnancy and followed 2 months after delivery. The stu dy was performed from the January 1996 to June 1996. Results. The resu lts showed 70% of abnormal pregnancies to have impaired TCD findings, mostly increased CBFV. The degree of toxemia measured by Goecke's inde x significantly correlated with abnormal CBFV. Nine gravidas with incr eased CBFV on the first examination developed vasospasm during 34 to 3 6 weeks of gravidity. No statistically significant difference of the M 1 segment of MCA diameters was found between normal (3.8 +/- 0.7 mm) a nd abnormal pregnancies (4.1 +/- 0.9 mm), Conclusions. The increase in the maternal CBFV was the most frequent observation in abnormal pregn ancies. It was progressive during late pregnancy, when vasospasm may d evelop, although the presence of vasospasm is still the matter of cont roversy The most important observation was that significant changes in CBFV preceded neurologic symptoms, emphasizing the predictive role of TCD in abnormal pregnancies.