scholarly journals Determining the effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and Middle Cerebral Arteries in Women with Severe Preeclampsia: A Prospective Study

2021 ◽  
pp. 111-122
Author(s):  
Osama M. Okab ◽  
Mona K. Omar ◽  
Emaad M. Mashaly ◽  
Dina G. El-kholy
Keyword(s):  
Serum Level ◽  
Prospective Study ◽  
Magnesium Sulfate ◽  
Pulsatility Index ◽  
Gestational Hypertension ◽  
Cerebral Arteries ◽  
Resistance Index ◽  
Severe Preeclampsia ◽  
Specific Syndrome ◽  
Middle Cerebral Arteries

Background: Preeclampsia is best described as a pregnancy-specific syndrome that can affect every organ system. Although preeclampsia is much more than simply gestational hypertension with proteinuria, appearance of proteinuria remains an important objective diagnostic criterion. The aim of this study is to evaluate Doppler velocimetric parameters (resistance index [RI], pulsatility index [PI], and systolic/diastolic [S/D] ratio) of the umbilical and middle cerebral arteries before and after magnesium sulfate administration in pregnant women with severe preeclampsia. Methods: This prospective study had been included 25 women from the emergency department and Obstetrics outpatient clinic Tanta University. Resistance index [RI], pulsatility index [PI] and systolic/ diastolic [S/D] ratio of middle cerebral artery and umbilical artery before and 20 minutes after intravenous administration of 6 grams of magnesium sulfate (loading dose). Results: The maternal age of cases included in the study ranged between 18 year and 40 year with a mean age of 32.03±6.1. The gravidity of cases included in the study ranged between 1 and 5 with a mean of 2.01±1.03.The parity of cases included in the study ranged between 0 and 6 with a mean of 2.18±1.04.The number of abortions ranged between 0 and 3whith a mean of 0.61±0.03. The serum level of ALT ranged between 11 and 104 mEq/L with a mean of 49.12±27.81. The serum level of AST ranged between 13 and 84 mEq/L with a mean of 42.5±20.17. The resistance index (RI) before MgSo4 administration ranged between 0.45 and 1.0 with a mean of 0.65 ± 0.15while it ranged between 0.4 and 0.9 after MgSo4 administration with a mean of 0.63± 0.13 .There was statistical significant differences between them (p<0.001). The pulsatility index (PI) before MgSo4 administration ranged between 0.6 and 2.15 with a mean of 1.15±0.45 while it ranged between 0.5 and 0.2 after MgSo4 administration with a mean of 1.04± 0.45 .There was statistical significant differences between them (p<0.001) . Conclusions: Infusion of MgSO4 significantly decreases the fetal RI-umbilical and PI-MCA and increases C/U ratio indices obtained with color Doppler ultrasound evaluations. 

Effect of the loading dose of magnesium sulfate on the Doppler velocimetry parameters in the uterine, umbilical and fetal middle cerebral arteries in severe preeclampsia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed A ElKady ◽  
Noha H Rabie ◽  
Mohammed H Mostafa ◽  
Amany M Hafez
Keyword(s):  
Blood Flow ◽  
Magnesium Sulfate ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Cerebral Arteries ◽  
Resistance Index ◽  
Severe Preeclampsia ◽  
Loading Dose ◽  
Doppler Velocimetry ◽  
Middle Cerebral Arteries

Abstract Background Preeclampsia is pregnancy-specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation. Aim of the Work to assess the effect of injecting magnesium sulfate on Doppler parameters of uterine artery, umbilical and fetal middle cerebral arteries (MCA) in women with severe preeclampsia. Patients and Methods This study included eighty pregnant with severe preeclampsia or eclampsia who were given magnesium sulphate therapy in Ain Shams University Maternity hospital. The Study group included 80 pregnant patients Doppler flow velocity parameters (resistance index [RI], pulsatility index [PI] and systolic/diastolic [S/D] ratio) were evaluated in the uterine, fetal umbilical and middle cerebral arteries before and 20 minutes after intravenous administration of 6 grams of magnesium sulfate (Loading dose). Results Magnesium sulfate had significant hemodynamic effects with significant reduction of systolic and diastolic blood pressure. Regarding the Doppler studies, it was found that after administration of magnesium sulfate there was significant reduction in the Doppler velocimetry parameters (Resistance index[RI], Pulsatility index[PI] and systolic/diastolic[S/D] ratio) in the uterine, umbilical and fetal middle cerebral arteries denoting decreased vascular resistance with increased blood flow in these vessels. Conclusion Intravenous administration of magnesium sulfate in pregnant women with severe preeclampsia and eclampsia resulted in a decrease in uterine artery, fetal umbilical and middle cerebral arteries Doppler indices with reduced resistance to blood flow in these vessels.

Effect of the Loading Dose of Magnesium Sulfate (MgSO4) on the Parameters of Doppler Flow Velocity in the Uterine, Umbilical and Middle Cerebral Arteries in Severe Preeclampsia

2009 ◽  
Vol 29 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Alex Sandro Rolland Souza ◽  
Melania Maria Ramos Amorim ◽  
Isabela Cristina, A. N. C. Coutinho ◽  
Marcelo Marques de Souza Lima ◽  
Carlos Noronha Neto ◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Flow Velocity ◽  
Cerebral Arteries ◽  
Severe Preeclampsia ◽  
Loading Dose ◽  
Doppler Flow ◽  
Middle Cerebral Arteries

scholarly journals Effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and Middle Cerebral Arteries in Women with Severe Preeclampsia

2012 ◽  
Vol 2 ◽  
pp. 85 ◽  
Author(s):  
Nazanin Farshchian ◽  
Negin Rezavand ◽  
Saeed Mohammadi
Keyword(s):  
Magnesium Sulfate ◽  
Doppler Ultrasound ◽  
Color Doppler ◽  
Cerebral Arteries ◽  
Color Doppler Ultrasound ◽  
Severe Preeclampsia ◽  
Resistivity Index ◽  
Middle Cerebral Arteries ◽  
Before And After ◽  
The Mean

Objective: To assess the effect of injecting magnesium sulfate on Doppler parameters of fetal umbilical and middle cerebral arteries (MCA) in women with severe preeclampsia. Materials and Methods: A total of 21 patients with severe preeclampsia admitted to Imam Reza Hospital, Kermanshah (Iran), were evaluated. Before and after administration of magnesium sulfate, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery and umbilical artery blood flow. Paired t-test was used for statistical analysis. Results: After injection of magnesium sulfate, the mean resistivity index (RI)-umbilical, and pulsatility index (PI)-cerebral showed a statistically significant reduction (P < 0.001). The cerebroumbilical C/U ratio increased after the intervention (P < 0.001). The PI-umbilical (P = 0.1) and pre- and post-RI-cerebral (P = 0.96) did not have statistically significant changes. Conclusions: Infusion of magnesium sulfate significantly decreases the flow in the fetus RI-umbilical and PI-MCA, and it increases C/U ratio indices in color Doppler ultrasound.

scholarly journals Cerebral haemodynamics in early puerperium: A prospective study

Ultrasound ◽  
2017 ◽  
Vol 25 (2) ◽  
pp. 107-114 ◽  
Author(s):  
GP Anzola ◽  
R Brighenti ◽  
M Cobelli ◽  
A Giossi ◽  
S Mazzucco ◽  
...  
Keyword(s):  
Prospective Study ◽  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Cerebral Artery ◽  
Cerebral Arteries ◽  
Velocity Ratio ◽  
Mean Flow ◽  
Middle Cerebral Arteries ◽  
A Prospective Study ◽  
Mean Flow Velocity

Aim Prospective study on 900 consecutive puerperae to assess normal values and range of the blood flow velocity in the middle cerebral artery in both hemispheres. Material and method M1 and M2 segments of both middle cerebral arteries were assessed in all subjects within 96 hours of delivery. Mean flow velocity was recorded after adjusting for insonation angle. Lindegaard index (LI = middle cerebral artery–Internal Carotid Artery mean flow velocity ratio) was calculated whenever the mean flow velocity exceeded 100 cm/second. Asymmetry indexes were calculated inter hemispherically for M1 and M2 segments separately. Results Mean flow velocities were 74 ± 17 and 72 ± 17 in right and 73 ± 17 and 72 ± 17 cm/second in the left M1 and M2, respectively. A total of 136 subjects (12.1%) exceeded the threshold of 100 cm/second, but LI was consistently <3 in all of them. Mean flow velocity was inversely and independently correlated to haemoglobin levels and to parity. Mean asymmetry indexes were 0.25 ± 23 in M1 and 0.45 ± 25 in M2. Conclusion Mean flow velocity in the middle cerebral artery of healthy subjects in early puerperium is higher than in age-matched non-puerperal women and may exceed the threshold of 100 cm/second with no evidence of intracranial spasm, because of blood loss during delivery. Mean flow velocity is independently correlated with parity. Right-to-left mean flow velocity asymmetry may reach 50% as a consequence of a transient imbalance in vascular tone regulation.

Serum Level of Magnesium Attained in Magnesium Sulfate Therapy for Severe Preeclampsia

2010 ◽  
Vol 19 (4) ◽  
pp. 387-390 ◽  
Author(s):  
Winit Phuapradit ◽  
Nopadol Saropala ◽  
Somchai Haruvasin ◽  
Pichai Thuvasethakul
Keyword(s):  
Serum Level ◽  
Magnesium Sulfate ◽  
Severe Preeclampsia

scholarly journals Assessment of maternal cerebral blood flow in patients with preeclampsia

2005 ◽  
Vol 58 (1-2) ◽  
pp. 68-71 ◽  
Author(s):  
Vesna Mandic ◽  
Zeljko Mikovic` ◽  
Milan Djukic ◽  
Mladenko Vasiljevic ◽  
Dejan Filimonovic ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Magnesium Sulfate ◽  
Cerebral Artery ◽  
Resistance Index ◽  
Severe Preeclampsia ◽  
Arterial Blood Flow ◽  
Clinical Test ◽  
Flow Measurements ◽  
Arterial Blood

Introduction Systemic vasoconstrktion in preeclamptic patients increases vascular resistance, and is manifested by increased arterial blood flow velocity. The aim of the study is to evaluate if there is a change of Doppler indices in maternal medial cerbral artery (MCA) in severe preeclampsia due to: 1) severity of clinical symptoms, 2) the beginning of eclamptic attack and 3) the application of anticonvidsive therapy. Material and methods A prospective clinical study included 92 pregnant women, gestational age 28-36 weeks. They were divided into three groups: normotensive (n=30), mild preeclampsia (n=33), and severe preeclampsia (n=29). We investigated maternal cerebral circulation by assessing the MCA. We registrated: pulsatility index (Pi), resistance index (Ri), Systolic/diastolic ratio (S/D), and the maximum systolic, end diastolic and medium velocity. Patients with severe preeclampsia were divided into two subgroups: subgroup 1 included patients without symptoms of threatening eclampsia (n=18; 62.06%); while subgroup 2 included those with symptoms of preeclampsia (n=11; 37.94%). All patients with severe preeclampsia were treated with magnesium sulfate (MgSO4), and cerebral blood flow was measured before and after the treatment. Statistical analysis was done by oneway ANOVA, Student t-test and t-paired sample test. The difference was considered to be significant if p < 0.05. Results Significantly increased Pi, Ri and all velocities were established in the group of patients with severe preeclampsia compared with the other two groups. In the group with severe preeclamsia we registrated significantly increased values of all velocities (patients with signs of threatening eclampsia). After MgSO4 treatment in patients with severe preeclampsia significantly decreased values of Pi, Ri, S/D ratio and all velocities were registered. Discussion In the studied group of patients with severe preclampsia we found increased velocity values, Pi and Ri, especially in patients with signs of threatened eclampsia, suggesting that blood vessels changes are most prominent in severe preeclampsia. Cerebral blood flow measurements can be used as a clinical test for the prediction of eclampsia. Magnesium-sulfate (MgSO4) has a significant role in prophylaxis and treatment of eclampsia, and, therefore, positive influence on reduction of cerebral ishemic lesions can be expected. Conclusion We can conclude that changes of the cerebral blood flow can be evaluated by evaluating blood flow velocities in the medial cerebral artery. Velocities tend to increase in severe preeclampsia, especially with signs of threatening eclampsia, and decrease after treatment with magnesium sulfate. Serial measurements of blood flow in medial cerebral artery in patients with severe preeclampsia may be used in prediction of eclampsia and in evaluation of magnesium sulfate therapy effects.

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