Kluft, Lynn Chagall (2020) IMPAIRED CEREBRAL AUTOREGULATION IN PREECLAMPSIA: ANTEPARTUM VS. POSTPARTUM. thesis, Medicine.
Full text available on request.Abstract
Objective To develop the knowledge of pathophysiology and the understanding of maternal cerebral hemodynamics in the pre- and postpartum period during preeclampsia and normotensive pregnancies. Methods In this prospective cohort study, South-African (n=57) women were enrolled at the maternity ward of Tygerberg Hospital in Cape Town, South Africa. The cerebral autoregulation of the middle cerebral artery (MCA) was analyzed in preeclamptic and normotensive pregnant women antepartum or/and postpartum. Transcranial Doppler ultrasound was used to measure the hemodynamics was used to measure the blood pressure. A non-invasive finger arterial volume clamping was used to measure the blood pressure. Data are shown as median (range) and mean (standard deviation). Statistical significance was set at p<.05 for statistical analyses. Results A lower cerebral autoregulation index antepartum was found in preeclamptic patients (Md=6.7 (2.7-8.8)) compared to normotensive pregnancies (Md=7.2 (5.0-8.8)). The autoregulation index was analyzed within the longitudinal subgroup and was compared before and after delivery. A trend of improved cerebral autoregulation was observed (Md=6.7 (4.0- 7.8) and Md=7.3 (3.0-9.0)). Cerebral autoregulation index of preeclamptic patients increased after 24-48 hours postpartum, however there was no significant difference (p=.088). There was no difference of ARI found in the normotensive group (Md=7.4 (5.0-8.8) and Md=7.00 (5.0-8.4)). Conclusion A lower cerebral autoregulation index was found in preeclamptic patients antepartum. In preeclamptic patients, a trend of improved autoregulation after delivery was observed. Generally, the cerebral autoregulation index of preeclamptic patients increased after 24-48 hours postpartum. Further research is needed to describe the exact pathophysiology of preeclampsia and investigate the impairment of cerebral autoregulation.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. van Veen, T.R. |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 Jan 2024 12:35 |
| Last Modified: | 09 Jan 2024 12:35 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3735 |
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