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Obstetrics & Gynecology 2002;100:931-939
© 2002 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Differential Blood Flow in Uterine, Ophthalmic, and Brachial Arteries of Preeclamptic Women

Masayo Takata, MD, Mikiya Nakatsuka, MD, PhD and Takafumi Kudo, MD, PhD

From the Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama, Japan.

Address reprint requests to: Mikiya Nakatsuka, MD, Okayama University Medical School, Department of Obstetrics and Gynecology, 2-5-1 Shikata, Okayama-City, Okayama, 700-8558 Japan; E-mail: mikiya{at}cc.okayama-u.ac.jp.

OBJECTIVE: To develop a method that employs noninvasive, pulsed Doppler ultrasonography combined with measurement of flow-mediated vasodilation to evaluate characteristic endothelial dysfunction in various degrees of preeclampsia.

METHODS: Uterine, ophthalmic, and brachial arterial blood flow of 99 pregnant women (control group [n = 32], non-preeclamptic intrauterine growth restriction group (n = 15), mild preeclampsia group [n = 25], and severe preeclampsia group [n = 27]) were evaluated by pulsed Doppler ultrasound or flow-mediated vasodilation.

RESULTS: Uterine, orbital, and brachial circulation were altered in preeclampsia, whereas no significant differences were observed between the non-preeclamptic intrauterine growth restriction and control groups. Pulsatility index in the uterine arteries of preeclamptic women with intrauterine growth restriction was approximately three-fold higher than that of normotensive women with or without intrauterine growth restriction. The peak ratio (defined to quantify characteristic flow velocity waveform) of the ophthalmic artery of hypertensive women was significantly higher than that of normotensive women. Flow-mediated vasodilation in the brachial artery of preeclamptic women with intrauterine growth restriction was significantly lower than that in preeclamptic women without intrauterine growth restriction. Among preeclamptic women, elevation of the resistance in the uterine artery and reduced flow-mediated vasodilation were closely correlated to intrauterine growth restriction, whereas the elevated peak ratio of the ophthalmic artery was dependent on hypertension, irrespective of the presence of intrauterine growth restriction.

CONCLUSION: Ultrasound evaluation of uterine and orbital circulation and flow-mediated vasodilation of the brachial artery helps differentiate the degree and severity of preeclampsia.




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