[Effect of magnesium sulfate on pulsatility index of uterine, umbilical and fetal middle cerebral arteries according to the persistence of bilateral diastolic notch of uterine arteries in patients with severe preeclampsia].
OBJECTIVE
To evaluate the effect of magnesium sulphate on the pulsatility index (PI) of the uterine, umbilical and fetal middle cerebral arteries, according to the persistency or not of the bilateral protodiastolic notch of the uterine arteries in severe pre-eclampsia.


METHODS
A cohort study including 40 pregnant women with severe pre-eclampsia, 23 of them presenting bilateral protodiastolic notch, and 17, unilateral/absent notch. The patients were submitted to Doppler velocimetry before and 20 minutes after the intravenous administration of 6 g of magnesium sulphate. The examination was carried out with the patient in semi-Fowler position, the sonograms being obtained during fetal inactivity, in apnea and absent uterine contraction periods. All the exams were performed by two researchers, the average being considered as the final result. Wilcoxon's test was used to compare the PI, before and after magnesium sulphate in both groups. The difference between the two measurements (before and after magnesium sulphate) was compared between the groups (bilateral incision and unilateral/absent incision) using the Mann-Whitney test.


RESULTS
There was a significant increase in the maternal heart rate (MHR) and decrease in the maternal blood pressure, and in the PI medians of the two uterine arteries and in the fetal middle cerebral artery, after magnesium sulphate in both groups. There was a significant decrease in the PI of the left uterine artery and in the umbilical artery, only in the protodiastolic unilateral/absent notch group. Nevertheless, it was not found any significant difference regarding the PI of the right uterine artery, or the cerebral/umbilical relationship, before and after magnesium sulphate in each group. No difference between the groups was found, before and after magnesium sulphate, for any of the studied outcomes.


CONCLUSIONS
After the intravenous administration of 6 g of magnesium sulphate to patients with severe pre-eclampsia, a decrease in blood pressure and in the PI of the uterine, umbilical and fetal middle cerebral arteries occurs, besides the increase in the MHR, not influenced by the presence of bilateral protodiastolic notch in the uterine arteries.
Souza
Alex Sandro Rolland
AS
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil. alexrolland@uol.com.br
Amorim
Melania Maria Ramos
MM
Santos
Roberta Espínola
RE
Noronha Neto
Carlos
C
Porto
Ana Maria Feitosa
AM
D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology*; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000494:pharmacology*; D020768:Middle Cerebral Artery / Q000187:drug effects* / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011674:Pulse; D012720:Severity of Illness Index; D014469:Umbilical Arteries / Q000187:drug effects* / Q000503:physiopathology*; D014599:Uterus / Q000098:blood supply* / Q000187:drug effects*
D000927:Anticonvulsants; D008278:Magnesium Sulfate