Cerebro vascular reactivity (CVR) of middle cerebral artery in response to CO2_5% inhalation in preeclamptic women

Abstract

Objective: To compare the cerebro vascular reactivity (CVR) of middle cerebral artery (MCA) in response to CO2_5% inhalation between preeclamptic and normotensive pregnant women, also, between mild and severe preeclampsia.

Study design: A comparative study was performed on 61 women with preeclampsia and 65 normotensive pregnant women who were in the third trimester of gestation. MCA transcranial Doppler ultrasound was used to measure CVR in response to CO2_5% inhalation. Pulsatility index (PI), resistance index (RI), blood pressure, maternal age, gestational age and gravidity were also recorded.

Results: Baseline PI and RI were lower in the preeclamptic group (p < 0.05). Inhalation of CO2_5% caused significant increase in CVR among normotensive pregnant women in comparison with preeclamptic group (1.006 ± 0.229 versus 0.503 ± 0.209, p = 0.0001). Significantly, more cerebral vasodilatation was found among mild preeclamptic women in comparison with severe preeclamptic women (0.583 ± 0.193 versus 0.383 ± 0.173, p = 0.0001). The receiver operating characteristics curve analysis revealed acceptable difference between CO2 stimulation test of preeclamptic and normotensive women (Area under curve = 0.973, p = 0.0001).

Conclusion: CVR in response to CO2_5% is less in preeclamptic pregnant women than normotensives, also, in severe preeclampsia, it is less than mild preeclampsia.

• Cerebro vascular reactivity
• middle cerebral artery
• preeclampsia
• pregnancy
• transcranial doppler ultrasound