Maternal cerebral centralization of blood flow in pregnant women with specific gestational hypertension

Abstract

Objectives

To evaluate the occurrence of maternal brain centralization in pregnant women with specific gestational hypertension; to establish normal values of the ratio of the uterine artery with (mean and standard deviation) ophthalmic artery; to compare the ratio of uterine to the ophthalmic artery with normal and abnormal groups; and to establish the Receiver Operator Curve (ROC) for diagnosis of patients with specific hypertensive disease of pregnancy.

Methods

To achieve the proposed objectives a case–control study was carried out where the sample consisted of 178 pregnant patients divided into two groups. The control group included pregnant 83 pregnant normotensive women; a case group included 95 patients with clinical and laboratory diagnoses of specific gestational hypertension.

Results

Patients with preeclampsia had lower values than the patients who had eclampsia. The Doppler parameters that were statistically significant were those of the ratio of uterine artery with the ophthalmic artery (AU/AO) and vice versa. A comparison between the normal curve systole–diastole and the respective cut-off point was performed. A ROC is shown in the cut-off considering the systolic velocity, the diastolic velocity, the systole/diastole relation, and the index of resistance of the ophthalmic artery.

Conclusion

The maternal centralization in high risk pregnancies was observed when specific gestational hypertension is real. The normal curve has a mean and standard deviation of the relative Doppler of the uterine artery to the ophthalmic artery systolic/diastolic ratio was 0.43 ± 0.16 for normal pregnant patients. Comparing the group of patients with normal pathological group of patients there was a statistically significant difference between them considering the relation of Doppler uterine artery with ophthalmic artery. The cut-off point was more sensitive, verified by ROC, which defines maternal brain centralization in patients with specific gestational hypertension as 0.57 for the Doppler systolic/diastolic ratio of the uterine artery compared with the ophthalmic artery, with 78% sensitivity and 13% false positive.