Maternal ophthalmic artery Doppler ultrasonography in preeclampsia and pregnancy outcomes

Objective: To examine the association of ophthalmic artery (OA) Doppler measure - the ratio of velocity peaks (PR) - to adverse pregnancy outcomes in preeclampsia. Study Design and main outcomes: Prospective cohort study of 56 women with preeclampsia that underwent Doppler measurements of OA flow, medial to optic nerve. PR results were classified as normal (PR < 0.78), abnormal (PR 0.78-0.98), or highly abnormal (PR >= 0.99). Attending clinicians were blinded to OA Doppler results. The primary endpoints were (1) a composite of adverse maternal outcomes-central nervous system injury (eclampsia or posterior reversible encephalopathy syndrome), HELLP syndrome, hypertensive crisis, maternal admission to the intensive care unit, and maternal death-and (2) a composite of adverse perinatal outcomes-birth weight < 10th percentile for gestational age, neonatal acidemia, 5-min Apgar score < 7, admission of infants weighing > 2500 g to the neonatal intensive care, preterm birth < 32 weeks, fetal or neonatal death. Results: Adverse maternal outcomes became more frequent as the PR values increased (p = .005). The occurrence of hypertensive crisis after hospital admission (secondary endpoint) was also positively associated with PR values (p =. 001). Adverse perinatal outcomes were not associated with PR values (p =. 551), but women in the highly abnormal PR group (PR >= 0.99) had the earliest deliveries (p =. 001) and the smallest newborns (p =. 004). All women in the highly abnormal PR group (n = 16) had an adverse outcome. Conclusions: Maternal OA Doppler PR >= 0.99 in preeclampsia may identify women at increased risk of adverse maternal outcomes and pregnancies at the greatest risk of preterm birth.