Predictors for severe preeclampsia in the third trimester of pregnancy according to periorbital Doppler findings

Objective. To reveal predictors for severe preeclampsia (PE) in the third trimester of pregnancy according to periorbital Doppler (POD) findings. Subject and methods. POD data were compared in 100 women with manifestations of hypertension occurring during pregnancy, including 20 with severe PE, 35 with moderate PE, and 45 with gestational hypertension. A comparison group included 74 women with physiologic pregnancy. The investigators recorded hemodynamic characteristics, such as peak blood flow velocity (PBFV) and pulsatility index (PI) in the ophthalmic artery (OA) and PBFV in the ophthalmic vein. Results. Normative POD values were obtained in patients with physiological pregnancy and in those with various forms of hypertension before antihypertensive therapy. Regression analysis ascertained critical OA PI values that corresponded to those in severe PE (1.23-1.24) with high sensitivity (94% in the left GA)/(96% in the right OA) and high specificity (100% in both eyes). These indicators may be used as a predictor for severe PE. Conclusion. The low OA PI values found in patients with severe PE are a sign of orbital vasodilatation and point to orbital hyperperfusion. Ophthalmic Doppler findings are relevant and may be used as markers to identify severe PE from other forms of hypertension.

preeclampsia, gestational hypertension, ophthalmic arteries, Doppler study, pregnancy