Chronic perfusion changes and reduction in preeclampsia incidence in pregnant smokers: an ophthalmic artery Doppler study

Paes, Maria Marta Bini Martins; Diniz, Angélica Lemos Debs

doi:10.3109/14767058.2014.978756

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…The ophthalmic artery, which is the first branch of the internal carotid artery and has embryological, anatomical and functional similarities with the intracranial vasculature, is an easily accessible vessel for Doppler assessment that provides information on the less accessible intracranial circulation. Cross-sectional studies have reported that, in pregnancies with pre-eclampsia (PE), compared to normal pregnancies, there is a decrease in impedance to flow and an increase in flow velocity in the ophthalmic arteries [1][2][3][4][5][6][7][8][9][10][11][12] . There is also some evidence that development of PE is preceded by a decrease in impedance to flow in the cerebral circulation 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Ophthalmic artery Doppler in prediction of pre‐eclampsia at 35–37 weeks' gestation

Sarno

Wright

Vieira

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives First, to examine the potential value of maternal ophthalmic artery Doppler at 35–37 weeks' gestation in the prediction of subsequent development of pre‐eclampsia (PE), and, second, to examine the variability between repeat measurements in the same eye and variability in measurements between the two eyes. Methods This was a prospective observational study in women attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation. The visit included recording of maternal demographic characteristics and medical history and assessment of flow velocity waveforms from the maternal ophthalmic artery. Waveforms were obtained in sequence from the right eye, left eye and again from the right and then left eye. We recorded the average of the four measurements, two from each eye, for the following four indices: first peak of systolic velocity; second peak of systolic velocity; pulsatility index; and the ratio of the second to first peak of systolic velocity (PSV ratio). The measurements of the four indices were standardized to remove the effects of maternal characteristics and elements from the medical history. The competing‐risks model was used to determine the detection rate (DR) of delivery with PE at any time and at < 3 weeks after assessment, at a 10% false‐positive rate (FPR), in screening by maternal factors alone and a combination of maternal factors and the adjusted value of each of the four ophthalmic artery indices. Results The study population of 2287 pregnancies contained 60 (2.6%) that developed PE, including 19 (0.8%) that delivered with PE at < 3 weeks after assessment. The DR, at 10% FPR, of delivery with PE at any time after assessment by maternal factors was 25.0% (95% CI, 14.7–37.9%), and this increased by 25 percentage points to 50.0% (95% CI, 36.8–63.2%) with the addition of the adjusted PSV ratio (P = 0.005); the respective values for delivery with PE at < 3 weeks after assessment were 31.6% (95% CI, 12.6–56.6%) and 57.9% (95% CI, 33.5–79.8%). The other ophthalmic artery indices did not improve the prediction provided by maternal factors alone. There was good correlation between the first and second measurements of PSV ratio from the same eye (right eye r = 0.823, left eye r = 0.840), but poorer correlation in the first and second measurements between the two eyes (first measurement r = 0.690, second measurement r = 0.682). In screening by maternal factors and PSV ratio for PE with delivery at any stage after assessment, the estimated DR, at 10% FPR, was 50.0% when the average of four measurements was used (two from each eye), 49.1% when the average of one measurement from each eye was used, 47.3% when the average of two measurements from the same eye was used, and 45.8% when only one measurement was used. Conclusions Ophthalmic artery PSV ratio at 35–37 weeks' gestation can predict subsequent delivery with PE, especially if this occurs within 3 weeks after assessment. In the assessment of ophthalmic artery Doppler, it is necessary to use the average of one measurement fr...

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Section: Introductionmentioning

confidence: 99%

Ophthalmic artery Doppler in prediction of pre‐eclampsia at 35–37 weeks' gestation

Sarno

Wright

Vieira

et al. 2020

Ultrasound in Obstet & Gyne

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show abstract

“…Several studies have reported consistently that, in women with established PE, compared to normotensive pregnancies, impedance to flow in the ophthalmic artery is reduced and systolic velocities are increased [1][2][3][4][5][6][7][8][9][10][11][12] . These findings suggest that PE is characterized by increased orbital and probably cerebral perfusion, and this is consistent with the hypothesis that PE is a hyperdynamic condition with increased cardiac output and compensatory vasodilation in both the cerebral and systemic circulation 3,6,27 .…”

Section: Interpretation Of Results and Comparison With Findings Of Previous Studiesmentioning

confidence: 99%

Relationship between ophthalmic artery Doppler and maternal cardiovascular function

Gibbone

Sapantzoglou

Nuñez-Cerrato

et al. 2021

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?This study of 2853 unselected pregnancies at 19-23 weeks' gestation found that the ophthalmic artery second to first peak of systolic velocity ratio (PSV ratio), which provides useful prediction of subsequent development of pre-eclampsia (PE), had very weak associations with indices of maternal cardiovascular function, but, in the subgroup that developed PE, there was a moderately strong association with left ventricular mass indexed for body surface area. What are the clinical implications of this work?The ophthalmic artery second systolic wave is a reflective one, and its increase, relative to the first systolic wave, is indicative of increased peripheral vascular resistance. The association between PSV ratio and left ventricular mass in women who develop PE suggests that cardiac structural changes are likely to be the result of the increase in peripheral vascular resistance.

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“…We should emphasize that this error in interpretation of the ophthalmic artery FVW was corrected in the latest publications of our group–, after finding that the peak ratio was the ratio between the two peaks of systolic elevation and not the ratio of the so‐called mesodiastolic velocity to the systolic velocity peak. As the ophthalmic artery is likely to be the focus of much research in hypertensive pregnant women, we feel it is important to point out and correct the description of the FVW phases, in order to allow new researchers to interpret correctly their findings.…”

mentioning

confidence: 96%

Conflict in interpretation of ophthalmic artery Doppler waveform

Diniz

2019

Ultrasound in Obstet & Gyne

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Chronic perfusion changes and reduction in preeclampsia incidence in pregnant smokers: an ophthalmic artery Doppler study

Abstract: Preeclamptic women have presented hyperperfusion whereas chronic smokers have shown hypoperfusion in ophthalmic artery. Thus, chronic flow changes in pregnant smokers might reduce the number of sudden and catastrophic events in preeclampsia.

Cited by 8 publications

References 35 publications

Ophthalmic artery Doppler in prediction of pre‐eclampsia at 35–37 weeks' gestation

Ophthalmic artery Doppler in prediction of pre‐eclampsia at 35–37 weeks' gestation

Relationship between ophthalmic artery Doppler and maternal cardiovascular function

Conflict in interpretation of ophthalmic artery Doppler waveform

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