title: Transcranial Doppler findings of cerebral vasospasm in preeclampsia.
abstract: The objective of this study was to evaluate the effect of preeclampsia and its severity on maternal mean middle cerebral artery blood flow velocity (mean MCA-CBFV) using transcranial doppler sonography (TCD), as well as the effect of magnesium on mean MCA-CBFV in preeclampsia. This study used a prospective, comparative design. TCD was used to examine maternal mean MCA-CBFV in both healthy subjects (controls) and preeclamptic subjects (cases). The two groups were similar in age, gestational age, and parity. Healthy subjects were categorized into three groups: Group I, 6-14 weeks, n = 10; Group II, 24-40 weeks, n = 27; Group III, postpartum n = 15, 12-36 h. Serial TCD examinations of the middle cerebral artery were completed in 21 preeclamptic subjects at four different points in time: Time I is an initial measurement before delivery; Time 2 is also before delivery but after magnesium had been administered. Time 3 is postpartum while on magnesium (12-24 h), Time 4 is postpartum off magnesium, (24-48 h). Preeclamptic subjects had significantly increased mean MCA-CBFV when compared to healthy subjects: antepartum (mean 78.2 vs. 55.1 cm/sec, P < 0.0005); postpartum (mean 101.3 vs. 69.8 cm/sec, P < 0.0001). Severe preeclamptics had significantly higher mean MCA-CBFV than mild preeclamptics at each point in time: Time 1: P < 0.016; Time 2: P < 0.040; Time 3: P < 0.002; and Time 4: P < 0.028. These data support the theory that cerebral vasospasm of the smaller diameter vessels is a major component of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA.
authors.forename: W F
authors.initials: WF
authors.lastname: Hansen
authors.forename: S J
authors.initials: SJ
authors.lastname: Burnham
authors.forename: T O
authors.initials: TO
authors.lastname: Svendsen
authors.forename: V L
authors.initials: VL
authors.lastname: Katz
authors.forename: J M
authors.initials: JM
authors.lastname: Thorp
authors.forename: A R
authors.initials: AR
authors.lastname: Hansen
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000502:physiology / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006400:Hematocrit; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D012016:Reference Values; D013599:Systole; D017585:Ultrasonography, Doppler, Transcranial