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Br J Obstet Gynaecol. 1993 Jan;100(1):85-91.

Noninvasive assessment of the maternal cerebral circulation by transcranial Doppler ultrasound during angiotensin II infusion.

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  • 1Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Maternity Hospital, Headington, Oxford, UK.

Abstract

OBJECTIVE:

To examine the relationship between experimentally induced increments in blood pressure and maternal middle cerebral artery flow velocity patterns measured by transcranial Doppler ultrasound (TCD).

DESIGN:

Prospective experimental study.

SETTING:

John Radcliffe Maternity Hospital, Oxford.

INTERVENTION:

Middle cerebral artery flow velocity waveforms were measured using 2 MHz pulsed Doppler ultrasound via the temporal cranial approach at 28 weeks gestation before, during and 10 min following an angiotensin II infusion.

SUBJECTS:

101 normotensive primiparous women at 28 weeks gestation.

RESULTS:

A significant rise in blood pressure and fall in heart rate were demonstrated between pre-infusion and maximum angiotensin II infusion (maximum blood pressure) recordings. Simultaneous changes were observed in all flow velocity indices, shown as a decrease in systolic velocity and pulsatility index, and an increase in diastolic and mean velocity (P < 0.0001). These values all returned to baseline levels 10 min post infusion (P < 0.0001). Statistical analysis suggested that the change in flow velocity is related to the rise in blood pressure rather than the direct effect of angiotensin II on the cerebral circulation.

CONCLUSION:

Transcranial Doppler can detect changes in the cerebral circulation associated with alterations in blood pressure during pregnancy. The technique needs to be evaluated further in hypertensive disease.

PMID:
8427845
[PubMed - indexed for MEDLINE]
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