Monteiro Viviane Nascimento Pereira, de Oliveira Cristiane Alves, Gomes Junior Saint Clair, do Cima Luciana Carneiro, Naves Wellington Ued, Diniz Angélica Lemes Debs, Araujo Júnior Edward, de Sá Renato Augusto Moreira
Unit of Fetal Medicine, National Institute of Women's, Children's and Adolescents' Health Fernandes Figueira, Oswaldo Cruz Foundation (IFF/Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Obstetrics, Fluminense Federal University (UFF), Niteroi, Rio de Janeiro, Brazil.
J Clin Ultrasound. 2025 Mar-Apr;53(3):504-509. doi: 10.1002/jcu.23899. Epub 2024 Nov 26.
This study aimed to evaluate the association between ophthalmic artery (OA) Doppler indices and adverse neonatal outcomes in women with pregnancies complicated by preeclampsia (PE).
A prospective cross-sectional study involving 110 pregnant women who were diagnosed with PE in the first 24 h of hospitalization was conducted at three hospitals in southeastern Brazil from April 2020 to December 2022. The ophthalmic parameters analyzed were the resistance index (RI), pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), ratio of PSV2 to PSV1 (PSV ratio or the peak ratio [PR]), and end-diastolic velocity (EDV). The outcome measures were neonatal death (during hospitalization), neonatal intensive care unit (ICU) admission, gestational age at delivery < 32 weeks, birth weight < 1500 g, birth weight < 10th percentile, the presence of comorbidities associated with prematurity, the use of invasive mechanical ventilation, an Apgar score at the 5th minute < 7.0, and signs of neurological impairment.
Pregnant women with severe features of PE showed higher values of systolic (152.8 ± 20.7 vs. 136.3 ± 11.9, p = 0.000) and diastolic (98.1 ± 12.8 vs. 88.1 ± 10.8, p = 0.000) blood pressure values and lower gestational age at admission (31.5 ± 3.8 vs. 33.7 ± 4.3, p = 0.009) than PE without severe features. No significant differences were found between the mean values of the OA Doppler indices when comparing the presence or absence of neonatal outcomes in the women with PE.
OA Doppler, while valuable for the prediction, diagnosis, and evaluation of adverse maternal outcomes, does not independently predict adverse neonatal outcomes in women with severe features of PE.
本研究旨在评估妊娠合并子痫前期（PE）的女性眼动脉（OA）多普勒指数与不良新生儿结局之间的关联。
2020年4月至2022年12月，在巴西东南部的三家医院进行了一项前瞻性横断面研究，纳入了110名在住院后24小时内被诊断为PE的孕妇。分析的眼科参数包括阻力指数（RI）、搏动指数（PI）、第一收缩期峰值速度（PSV1）、第二收缩期峰值速度（PSV2）、PSV2与PSV1的比值（PSV比值或峰值比值[PR]）以及舒张末期速度（EDV）。结局指标包括新生儿死亡（住院期间）、新生儿重症监护病房（ICU）入院、分娩时孕周<32周、出生体重<1500g、出生体重<第10百分位数、存在与早产相关的合并症、使用有创机械通气、5分钟时阿氏评分<7.0以及神经功能障碍体征。
具有重度PE特征的孕妇收缩压（152.8±20.7 vs. 136.3±11.9，p = 0.000）和舒张压（98.1±12.8 vs. 88.1±10.8，p = 0.000）值更高，入院时孕周更低（31.5±3.8 vs. 33.7±4.3，p = 0.009），与无重度特征的PE孕妇相比。在比较PE女性中有无新生儿结局时，OA多普勒指数的平均值之间未发现显著差异。
OA多普勒虽然对预测、诊断和评估不良孕产妇结局有价值，但不能独立预测具有重度PE特征的女性的不良新生儿结局。
