Persistent cerebrovascular changes in postpartum preeclamptic women: a Doppler evaluation.
OBJECTIVE: Our goal was to evaluate the cerebral vasculature in postpartum normotensive and preeclamptic women. STUDY DESIGN: Nineteen previously preeclamptic women and 19 matched normotensive controls were studied at 6 weeks, and 8 preeclamptic women and 28 normotensive controls were studied at 12 weeks post partum. Systolic, diastolic, and mean velocities, as well as resistance and pulsatility indexes, of the middle cerebral, ophthalmic, and central retinal arteries were recorded. Data are presented as median and range. Statistical significance was set at p < 0.05. RESULTS: There were no differences in maternal age, parity, heart rate, mean arterial pressure, and proteinuria between the two groups at 6 and 12 weeks post partum. At 6 weeks post partum the preeclamptic group had higher ophthalmic artery diastolic velocity (9.0 cm/sec, 3.1 to 22.3, vs 5.4 cm/sec, 3.0 to 20.1; p = 0.008), ophthalmic artery mean velocity (6.0 cm/sec, 8.8 to 34.8, vs 12.5 cm/sec, 6.8 to 35.4; p = 0.03), and central retinal artery systolic velocity (10.0 cm/sec, 7.6 to 28.0, vs 8.4 cm/sec, 5.2 to 18.3; p = 0.02). The ophthalmic artery resistance index (0.72, 0.43 to 0.88, vs 0.79, 0.66 to 0.90; p = 0.03) and ophthalmic artery pulsatility index (1.56, 0.94 to 2.82, vs 2.03, vs 1.13 to 3.10; p = 0.04) were lower in the preeclamptic group. At 12 weeks post partum the preeclamptic group had elevated ophthalmic artery mean velocity (14.5 cm/sec, 7.9 to 20.2, vs 10.9 cm/sec, 5.5 to 15.4 p = 0.01), central retinal artery systolic velocity (11.1 cm/sec, 6.8 to 15.9, vs 8.5, 5.1 to 15.3; p = 0.02), and central retinal artery diastolic velocity (3.9 cm/sec, 1.2 to 5.2, vs 3.0, 1.4 to 5.8; p < 0.05). CONCLUSION: In the postpartum period preeclamptic women show persistently elevated central retinal artery systolic velocity, which suggests distal vasoconstriction.