[Doppler of the umbilical and fetal middle cerebral arteries after magnesium sulfate in preeclampsia].
BACKGROUND
To compare the ratio between the fetal middle cerebral artery and the umbilical artery using Doppler flow velocimetry indices (resistance index, pulsatility index and A/B relation) before and after administration of magnesium sulfate to pregnant women with severe preeclampsia (pure or superimposed).


METHODS
A prospective cohort study was conducted with each pregnant woman representing her own control. Forty severe preeclamptic women were included and underwent Doppler sonography before and 20 minutes after administration of 6g of magnesium sulfate. Analysis variables were the Doppler flow velocimetry indices evaluating the ratio of the fetal middle cerebral artery to the umbilical artery. To compare the mean indices before and after magnesium sulfate for the same patient, the "t-paired" Student test was used. The Stuart-Maxwell c(2) was applied to determine the difference of fetal diagnosis (normal, brain-sparing or reduced middle cerebral artery resistance) before and after magnesium sulfate.


RESULTS
No significant difference of the mean ratio between the middle cerebral artery and the umbilical artery, before and after administration of magnesium sulfate was observed. After magnesium sulfate (25.0% x 47.5%; p= 0.01), there was an increased frequency of isolated lower Doppler flow velocimetry indices in the middle cerebral artery.


CONCLUSIONS
Intravenous administration of magnesium sulfate in patients with severe preeclampsia is associated with increased frequency of fetal Doppler diagnosis of reduced resistance in the middle cerebral artery.
Souza
Alex Sandro Rolland
AS
Instituto Materno Infantil Professor Fernando Figueira (IMIP) e no Centro de Atenção à Mulher - Setor de Medicina FetaL, Recife, PE. alexrolland@uol.com.br
Amorim
Melania Maria Ramos
MM
Coêlho
Isabela Coutinho Neiva
IC
Lima
Marcelo Marques de Souza
MM
Noronha Neto
Carlos
C
Figueroa
José Natal
JN
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure; D005260:Female; D005333:Fetus / Q000098:blood supply* / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D017078:Laser-Doppler Flowmetry; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology*; D055815:Young Adult
D000927:Anticonvulsants; D008278:Magnesium Sulfate