Comparison of the resistive indices obtained in the uterine artery and the ophthalmic artery in preeclamptic and normotensive patients in Doppler US

Abstract

Introduction Preeclampsia is a medical condition characterized by hypertension and proteinuria during pregnancy, with the symptoms generally manifesting in the 3 rd trimester. Hypertension brings hemodynamic changes; it is therefore expected that arterial blood flow velocity waveforms will be different in the uterine and ophthalmic arteries in preeclampsia. Vascular changes do occur in preeclampsia, which in turn induces hemodynamic changes. Aim To compare mean values of the resistive index of the ophthalmic and uterine arteries in patients with preeclampsia and normotensive individuals in Doppler US. Methods In this cross-sectional observational study, ultrasound of the uterine and ophthalmic arteries was performed in 60 pregnant women in the 2 nd and 3 rd trimester of pregnancy to compare the resistive index of these arteries in preeclamptic and normotensive individuals. All the patients, i.e. 30 preeclamptic and 30 normotensive pregnant women, took part in this study voluntarily. The study was approved by the institutional review board (IRB) of the University of Lahore. Results The mean resistive index of the uterine artery was 0.50 ± 0.08 in normotensive participants and 0.64 ± 0.09 in preeclamptic women, with the p -value <0.001. The mean resistive index of the ophthalmic artery was 0.70 ± 0.05 in normotensive participants and 0.63 ± 0.04 in preeclamptic women, with the p -value <0.001. Conclusions There was a significant negative correlation between the resistive index of the uterine and ophthalmic arteries among the patients with preeclampsia and a significant positive correlation among normotensive individuals. Preeclampsia could be easily diagnosed with Doppler ultrasound based on hemodynamic changes in response to vascular changes in the ophthalmic and uterine arteries.

Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

“…In seven studies evaluated, the mean RI difference for overall PE was -0.07 (95% CI -0.09; -0.04), I2 = 81% with cut-offs established by the primary studies of 0.62 15 , 0.64 16 , 0.66 12,17 , 0.67 18 , 0.68 13,30 (Supplement 8). In the mild PE group there were seven studies with mean difference of -0.02 (95% CI -0.14; 0.09), I2 = 99% with cut-offs of 0.63 31 , 0.641 4 , 0.66 15 , 0.73 32,33 , 0.77 11 , 0.97 19 (Supplement 9).…”

“…Five studies had uncertain risks in the patient selection and ow and timing domains. 11,30,31,32,33 The study by Madina et al 16 scored low and risk of bias in the assessment of applicability concerns involving the index and standard tests, as it did not specify how pregnant women were allocated or the parameters used to de ne preeclampsia in the methodology.…”

“…8 Several studies have described changes in the velocity wave pattern of the ophthalmic artery in women with PE, both prenatally and in the postpartum, with signs of decreased impedance and orbital hyperperfusion, represented by high values of peak ratio (PR), the second peak of systolic velocity (P2) and decreased resistance index (RI) and pulsatility index (PI). [9][10][11][12][13][14][15][16][17][18][19] However, there is no consensus in the literature about what is the best diagnostic parameter of OAD in pregnant women with PE. The aid of this ultrasound examination may be relevant if used in the hospital environment to diagnose patients with PE where this information is urgently needed, to optimize care and facilitate early treatment, especially in severe cases.…”

Doppler parameters of ophthalmic artery in women with preeclampsia: A meta‐analysis

“…full-text review of the remaining 13 articles led us to identify 8 observational studies that met the inclusion criteria, comprising 640 pregnant women with or without confirmed preeclampsia. [13][14][15][16][17][18][19]25,34 Details on the literature search are displayed in Figure 1. Five case-control and 3 cross-sectional studies were enrolled.…”

“…13 The value of ophthalmic artery Doppler parameters as predictive tools for preeclampsia recently have assessed by an increased number of studies, however, the results are heterogeneous, and no clear consensus has been achieved regarding their exact role in clinical practice. [13][14][15][16][17][18][19][20][21][22][23][24][25] The aim of this meta-analysis was to investigate the potential significance of ophthalmic Doppler parameters in preeclamptic women and to provide evidence-based hints for both clinical practice and scientific investigation.…”