Doppler transcraneal en pre-eclampsia
Transcranial Doppler in pre-eclampsia
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Vargas Malaver, F. J. (2014). Doppler transcraneal en pre-eclampsia. Revista Repertorio De Medicina Y Cirugía, 23(4), 253–259. https://doi.org/10.31260/RepertMedCir.v23.n4.2014.694
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La preeclampsia es una afección multisistémica durante el embarazo, con alta tasa de morbilidad y mortalidad en la madre y el hijo. Dentro del espectro de efectos está la alteración del flujo sanguíneo cerebral que en ocasiones se asocia con convulsiones (eclampsia). Se ha intentado encontrar un método diagnóstico para su detección temprana, iniciar la terapia oportuna y reducir los efectos negativos. El doppler transcraneal es un examen no invasivo, de bajo costo y seguro, que puede tener un valor diagnóstico. El objetivo del artículo es una revisión sobre la utilidad del doppler transcraneal y la preeclampsia. Se buscó en la base de datos PubMed con términos MeSh. Diferentes estudios revelan índices de resistencia y pulsatilidad disminuidos en el segundo trimestre del embarazo, los cuales pueden predecir la aparición de preeclampsia. Abreviaturas: PRE-E, preeclampsia.
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1. Wagner LK. Diagnosis and management of preeclampsia. Am Fam Physician. 2004;70(12):2317-24.
2. Sibai BM. Diagnosis and management of chronic hypertension in pregnancy. Obstet Gynecol. 1991;78(3 Pt 1):451-61.
3. Sibai BM. Diagnosis and management of gestational hypertension and pre-eclampsia. Obstet Gynecol. 2003;102(1):181-92.
4. Williams K, Galerneau F. Maternal transcranial Doppler in pre-eclampsia and eclampsia. Ultrasound Obstet Gynecol. 2003;21(5):507-13.
5. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.
6. ACOG technical bulletin. Hypertension in pregnancy. Number 219--January 1996 (replaces no. 91, February 1986). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1996;53(2):175-83.
7. Cotton DB, Lee W, Huhta JC, Dorman KF. Hemodynamic profile of severe pregnancy-induced hypertension. Am J Obstet Gynecol. 1988;158(3 Pt 1):523-9.
8. Roberts JM, Taylor RN, Musci TJ, Rodgers GM, Hubel CA, McLaughlin MK. Preeclampsia: an endothelial cell disorder. Am J Obstet Gynecol. 1989;161(5):1200-4.
9. Kublickas M, Lunell NO, Nisell H, Westgren M. Maternal renal artery blood flow velocimetry in normal and hypertensive pregnancies. Acta Obstet Gynecol Scand. 1996;75(8):715-9.
10. Belfort MA, Grunewald C, Saade GR, Varner M, Nisell H. Preeclampsia may cause both overperfusion and underperfusion of the brain: a cerebral perfusion based model. Acta Obstet Gynecol Scand. 1999;78(7):586-91.
11. Riskin-Mashiah S, Saade GR, Herd JA. Cerebrovascular reactivity in normal pregnancy and preeclampsia. Obstet Gynecol. 2001 Nov; 98(5 Pt 1):827-32.
12. Belfort MA, Tooke-Miller C, Allen JC, Varner MA, Grunewald C, Nisell H, et al. Pregnant women with chronic hypertension and superimposed pre-eclampsia have high cerebral perfusion pressure. BJOG. 2001; 108(11):1141-7
13. Horn EH, Filshie M, Kerslake RW, Jaspan T, Worthington BS, Rubin PC. Widespread cerebral ischaemia treated with nimodipine in a patient with eclampsia. Br Med J. 1990;301(6755):794.
14. Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry. 1988 Mar; 51(3):416-21.
15. Fredriksson K, Lindvall O, Ingemarsson I, Astedt B, Cronqvist S, Holtås S. Repeated cranial computed tomographic and magnetic resonance imaging scans in two cases of eclampsia. Stroke. 1989;20(4):547-53.
16. Osborn AG. Osborn’s brain : imaging, pathology, and anatomy. 1st ed. Salt Lake City, Utah: Amirsys; 2004.
17. Trommer BL, Homer D, Mikhael MA. Cerebral vasospasm and eclampsia. Stroke. 1988; 19(3):326-9.
18. Schatlo B, Pluta RM. Clinical applications of transcranial Doppler sonography. Rev Recent Clin Trials. 2007;2(1):49-57.
19. Zwiebel WJ. Zwuebel ́s Doppler general: introducción a la ultrasonografia vascular. Madrid: Marbán, Elsevier; 2008.
20. Wells PN, Skidmore R. Doppler developments in the last quinquennium. Ultrasound Med Biol. 1985;11(4):613-23.
21. Taylor KJ, Holland S. Doppler US. Part I. Basic principles, instrumentation, and pitfalls. Radiology. 1990;174(2):297-307.
22. Gosling RG. Doppler ultrasound assessment of occlusive arterial disease. Practitioner. 1978;220(1318):599-609.
23. Pourcelot L. Applications cliniques de l ́ examen Doppler transcutane. In: Peronneau P, editor. Velocimetrie Ultrasonore Doppler. Paris: INSERM; 1974. p. 780-5.
24. Lindqvist PG, Marsál K, Pirhonen JP. Maternal cerebral Doppler velocimetry before, during, and after a normal pregnancy: a longitudinal study. Acta Obstet Gynecol Scand. 2006; 85(11):1299-303.
25. Easterling TR, Benedetti TJ, Schmucker BC, Millard SP. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet Gynecol. 1990;76(6):1061-9.
26. Bosio PM, McKenna PJ, Conroy R, O›Herlihy C. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol. 1999;94(6):978-84.
27. Spaanderman ME, Meertens M, van Bussel M, Ekhart TH, Peeters LL. Cardiac output increases independently of basal metabolic rate in early human pregnancy. Am J Physiol Heart Circ Physiol. 2000;278(5):H1585-8.
28. Ikeda T, Ikenoue T, Mori N, Nagamachi S, Jinnouchi S, Futami S, et al. Effect of early pregnancy on maternal regional cerebral blood. Am J Obstet Gynecol. 1993 Apr; 168(4):1303-8.
29. Williams K, Wilson S. Maternal middle cerebral artery blood flow velocity variation with gestational age. Obstet Gynecol. 1994;84(3):445-8.
30. Ikeda T, Mori N. Assessment of cerebral hemodynamics in pregnant women by internal carotid artery pulsed Doppler velocimetry. Am J Obstet Gynecol. 1990;163(2):494-8.
31. Belfort MA, Tooke-Miller C, Allen JC Jr, Saade GR, Dildy GA, Grunewald C, et al. Changes in flow velocity, resistance indices, and cerebral perfusion pressure in the maternal middle cerebral artery distribution during normal pregnancy. Acta Obstet Gynecol Scand. 2001 Feb; 80(2): p. 104–12
32. Ringelstein EB, Otis SM. Physiological testing of vasomotor reserve. In: Newell DW, Aaslid R, editors. Transcranial Doppler. New York: Raven Press; 1992. p. 83-100
33. Will AD, Lewis KL, Hinshaw DB Jr, Jordan K, Cousins LM, Hasso AN, et al. Cerebral vasoconstriction in toxemia. Neurology. 1987 Sep; 37(9):1555-7.
34. Lewis LK, Hinshaw DB Jr, Will AD, Hasso AN, Thompson JR. CT and angiographic correlation of severe neurological disease in toxemia of pregnancy. Neuroradiology. 1988; 30(1):59-64.
35. Zatik J, Aranyosi J, Settakis G, Páll D, Tóth Z, Limburg M, et al. Breath holding test in preeclampsia: lack of evidence for altered cerebral vascular reactivity. Int J Obstet Anesth. 2002;11(3):160-3.
36. Demarin V, Rundek T, Hodek B. Maternal cerebral circulation in normal and abnormal pregnancies. In: T R, editor. Scand Acta Obstet Gynecol Scand. 1997 Aug;76(7):619-24.
37. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631-44.
38. Zeeman GG. Neurologic complications of pre-eclampsia. Semin Perinatol. 2009;33(3):166-72.
39. Sherman RW, Bowie RA, Henfrey MM, Mahajan RP, Bogod D. Cerebral haemodynamics in pregnancy and pre-eclampsia as assessed by transcranial Doppler ultrasonography. Br J Anaesth. 2002;89(5):687-92.
40. Belfort MA, Saade GR, Yared M, Grunewald C, Herd JA, Varner MA, et al. Change in estimated cerebral perfusion pressure after treatment with nimodipine or magnesium sulfate in patients with preeclampsia. Am J Obstet Gynecol. 1999;181(2):402-7.
41. Williams KP, Wilson S. Variation in cerebral perfusion pressure with different hypertensive states in pregnancy. Am J Obstet Gynecol. 1998 Nov; 179(5):1200-3.
42. Hauser RA, Lacey DM, Knight MR. Hypertensive encephalopathy. Magnetic resonance imaging demonstration of reversible cortical and white matter lesions. Arch Neurol. 1988 Oct; 45(10):1078-83.
43. Chester EM, Agamanolis DP, Banker BQ, Victor M. Hypertensive encephalopathy: a clinicopathologic study of 20 cases. Neurology. 1978; 28(9 Pt 1):928-39.
44. Strandgaard S, Paulson OB. Cerebral autoregulation. Stroke. 1984;15(3):413-6.
45. Belfort MA, Saade GR, Grunewald C, Dildy GA, Varner MA, Nisell H. Effects of blood pressure on orbital and middle cerebral artery resistances in healthy pregnant women and women with preeclampsia. Am J Obstet Gynecol. 1999;180(3 Pt 1):601-7.
46. Redman CW. Eclampsia still kills. Br Med J (Clin Res Ed). 1988 Apr 30; 296(6631):1209-10.
47. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982;57(6):769-74.
48. Riskin-Mashiah S, Belfort MA, Saade GR, Herd JA. Transcranial doppler measurement of cerebral velocity indices as a predictor of preeclampsia. Am J Obstet Gynecol. 2002;187(6):1667-72.
49. Belfort M, Van Veen T, White GL, Kofford S, Allred J, Postma I, et al. Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre-eclampsia. Ultrasound Obstet Gynecol. 2012;40(4):406-11.
50. Zunker P, Happe S, Georgiadis AL, Louwen F, Georgiadis D, Ringelstein EB. Maternal cerebral hemodynamics in pregnancy-related hypertension. A prospective transcranial Doppler study. Ultrasound Obstet Gynecol. 2000 Aug; 16(2):179-87.
51. Williams KP, Moutquin JM. Do maternal cerebral vascular changes assessed by transcranial Doppler antedate pre-eclampsia?. Ultrasound Obstet Gynecol. 2004;23(3):254-6.
52. Martin JN, Blake PG, Perry KG, McCaul JF, Hess LW, Martin RW. The natural history of HELLP syndrome: patterns of disease progression and regression. Am J Obstet Gynecol. 1991;164(6 Pt 1):1500-9; discussion 9-13.
53. Williams KP, Wilson S. Maternal middle cerebral artery velocity changes in HELLP syndrome versus pre-eclampsia. Ultrasound Obstet Gynecol. 1998 Mar; 11(3):195-8.
54. Williams KP, Wilson S. Maternal cerebral blood flow changes associated with eclampsia. Am J Perinatol. 1995;12(3):189-91.
55. Belfort MA, Moise KJ Jr. Effect of magnesium sulfate on maternal brain flow in pre-eclampsia: a randomized, placebo-controlled study. Am J Obstet Gynecol. 1992 Sep; 167(3):661-6.
56. Naidu S, Payne AJ, Moodley J, Hoffmann M, Gouws E. Randomized study assessing the effect of phenytoin and magnesium sulphate on maternal cerebral circulation in eclampsia using transcranial Doppler ultrasound. Br J Obstet Gynaecol. 1996 Feb; 103(2):111-6.
2. Sibai BM. Diagnosis and management of chronic hypertension in pregnancy. Obstet Gynecol. 1991;78(3 Pt 1):451-61.
3. Sibai BM. Diagnosis and management of gestational hypertension and pre-eclampsia. Obstet Gynecol. 2003;102(1):181-92.
4. Williams K, Galerneau F. Maternal transcranial Doppler in pre-eclampsia and eclampsia. Ultrasound Obstet Gynecol. 2003;21(5):507-13.
5. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.
6. ACOG technical bulletin. Hypertension in pregnancy. Number 219--January 1996 (replaces no. 91, February 1986). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1996;53(2):175-83.
7. Cotton DB, Lee W, Huhta JC, Dorman KF. Hemodynamic profile of severe pregnancy-induced hypertension. Am J Obstet Gynecol. 1988;158(3 Pt 1):523-9.
8. Roberts JM, Taylor RN, Musci TJ, Rodgers GM, Hubel CA, McLaughlin MK. Preeclampsia: an endothelial cell disorder. Am J Obstet Gynecol. 1989;161(5):1200-4.
9. Kublickas M, Lunell NO, Nisell H, Westgren M. Maternal renal artery blood flow velocimetry in normal and hypertensive pregnancies. Acta Obstet Gynecol Scand. 1996;75(8):715-9.
10. Belfort MA, Grunewald C, Saade GR, Varner M, Nisell H. Preeclampsia may cause both overperfusion and underperfusion of the brain: a cerebral perfusion based model. Acta Obstet Gynecol Scand. 1999;78(7):586-91.
11. Riskin-Mashiah S, Saade GR, Herd JA. Cerebrovascular reactivity in normal pregnancy and preeclampsia. Obstet Gynecol. 2001 Nov; 98(5 Pt 1):827-32.
12. Belfort MA, Tooke-Miller C, Allen JC, Varner MA, Grunewald C, Nisell H, et al. Pregnant women with chronic hypertension and superimposed pre-eclampsia have high cerebral perfusion pressure. BJOG. 2001; 108(11):1141-7
13. Horn EH, Filshie M, Kerslake RW, Jaspan T, Worthington BS, Rubin PC. Widespread cerebral ischaemia treated with nimodipine in a patient with eclampsia. Br Med J. 1990;301(6755):794.
14. Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry. 1988 Mar; 51(3):416-21.
15. Fredriksson K, Lindvall O, Ingemarsson I, Astedt B, Cronqvist S, Holtås S. Repeated cranial computed tomographic and magnetic resonance imaging scans in two cases of eclampsia. Stroke. 1989;20(4):547-53.
16. Osborn AG. Osborn’s brain : imaging, pathology, and anatomy. 1st ed. Salt Lake City, Utah: Amirsys; 2004.
17. Trommer BL, Homer D, Mikhael MA. Cerebral vasospasm and eclampsia. Stroke. 1988; 19(3):326-9.
18. Schatlo B, Pluta RM. Clinical applications of transcranial Doppler sonography. Rev Recent Clin Trials. 2007;2(1):49-57.
19. Zwiebel WJ. Zwuebel ́s Doppler general: introducción a la ultrasonografia vascular. Madrid: Marbán, Elsevier; 2008.
20. Wells PN, Skidmore R. Doppler developments in the last quinquennium. Ultrasound Med Biol. 1985;11(4):613-23.
21. Taylor KJ, Holland S. Doppler US. Part I. Basic principles, instrumentation, and pitfalls. Radiology. 1990;174(2):297-307.
22. Gosling RG. Doppler ultrasound assessment of occlusive arterial disease. Practitioner. 1978;220(1318):599-609.
23. Pourcelot L. Applications cliniques de l ́ examen Doppler transcutane. In: Peronneau P, editor. Velocimetrie Ultrasonore Doppler. Paris: INSERM; 1974. p. 780-5.
24. Lindqvist PG, Marsál K, Pirhonen JP. Maternal cerebral Doppler velocimetry before, during, and after a normal pregnancy: a longitudinal study. Acta Obstet Gynecol Scand. 2006; 85(11):1299-303.
25. Easterling TR, Benedetti TJ, Schmucker BC, Millard SP. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet Gynecol. 1990;76(6):1061-9.
26. Bosio PM, McKenna PJ, Conroy R, O›Herlihy C. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol. 1999;94(6):978-84.
27. Spaanderman ME, Meertens M, van Bussel M, Ekhart TH, Peeters LL. Cardiac output increases independently of basal metabolic rate in early human pregnancy. Am J Physiol Heart Circ Physiol. 2000;278(5):H1585-8.
28. Ikeda T, Ikenoue T, Mori N, Nagamachi S, Jinnouchi S, Futami S, et al. Effect of early pregnancy on maternal regional cerebral blood. Am J Obstet Gynecol. 1993 Apr; 168(4):1303-8.
29. Williams K, Wilson S. Maternal middle cerebral artery blood flow velocity variation with gestational age. Obstet Gynecol. 1994;84(3):445-8.
30. Ikeda T, Mori N. Assessment of cerebral hemodynamics in pregnant women by internal carotid artery pulsed Doppler velocimetry. Am J Obstet Gynecol. 1990;163(2):494-8.
31. Belfort MA, Tooke-Miller C, Allen JC Jr, Saade GR, Dildy GA, Grunewald C, et al. Changes in flow velocity, resistance indices, and cerebral perfusion pressure in the maternal middle cerebral artery distribution during normal pregnancy. Acta Obstet Gynecol Scand. 2001 Feb; 80(2): p. 104–12
32. Ringelstein EB, Otis SM. Physiological testing of vasomotor reserve. In: Newell DW, Aaslid R, editors. Transcranial Doppler. New York: Raven Press; 1992. p. 83-100
33. Will AD, Lewis KL, Hinshaw DB Jr, Jordan K, Cousins LM, Hasso AN, et al. Cerebral vasoconstriction in toxemia. Neurology. 1987 Sep; 37(9):1555-7.
34. Lewis LK, Hinshaw DB Jr, Will AD, Hasso AN, Thompson JR. CT and angiographic correlation of severe neurological disease in toxemia of pregnancy. Neuroradiology. 1988; 30(1):59-64.
35. Zatik J, Aranyosi J, Settakis G, Páll D, Tóth Z, Limburg M, et al. Breath holding test in preeclampsia: lack of evidence for altered cerebral vascular reactivity. Int J Obstet Anesth. 2002;11(3):160-3.
36. Demarin V, Rundek T, Hodek B. Maternal cerebral circulation in normal and abnormal pregnancies. In: T R, editor. Scand Acta Obstet Gynecol Scand. 1997 Aug;76(7):619-24.
37. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631-44.
38. Zeeman GG. Neurologic complications of pre-eclampsia. Semin Perinatol. 2009;33(3):166-72.
39. Sherman RW, Bowie RA, Henfrey MM, Mahajan RP, Bogod D. Cerebral haemodynamics in pregnancy and pre-eclampsia as assessed by transcranial Doppler ultrasonography. Br J Anaesth. 2002;89(5):687-92.
40. Belfort MA, Saade GR, Yared M, Grunewald C, Herd JA, Varner MA, et al. Change in estimated cerebral perfusion pressure after treatment with nimodipine or magnesium sulfate in patients with preeclampsia. Am J Obstet Gynecol. 1999;181(2):402-7.
41. Williams KP, Wilson S. Variation in cerebral perfusion pressure with different hypertensive states in pregnancy. Am J Obstet Gynecol. 1998 Nov; 179(5):1200-3.
42. Hauser RA, Lacey DM, Knight MR. Hypertensive encephalopathy. Magnetic resonance imaging demonstration of reversible cortical and white matter lesions. Arch Neurol. 1988 Oct; 45(10):1078-83.
43. Chester EM, Agamanolis DP, Banker BQ, Victor M. Hypertensive encephalopathy: a clinicopathologic study of 20 cases. Neurology. 1978; 28(9 Pt 1):928-39.
44. Strandgaard S, Paulson OB. Cerebral autoregulation. Stroke. 1984;15(3):413-6.
45. Belfort MA, Saade GR, Grunewald C, Dildy GA, Varner MA, Nisell H. Effects of blood pressure on orbital and middle cerebral artery resistances in healthy pregnant women and women with preeclampsia. Am J Obstet Gynecol. 1999;180(3 Pt 1):601-7.
46. Redman CW. Eclampsia still kills. Br Med J (Clin Res Ed). 1988 Apr 30; 296(6631):1209-10.
47. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982;57(6):769-74.
48. Riskin-Mashiah S, Belfort MA, Saade GR, Herd JA. Transcranial doppler measurement of cerebral velocity indices as a predictor of preeclampsia. Am J Obstet Gynecol. 2002;187(6):1667-72.
49. Belfort M, Van Veen T, White GL, Kofford S, Allred J, Postma I, et al. Low maternal middle cerebral artery Doppler resistance indices can predict future development of pre-eclampsia. Ultrasound Obstet Gynecol. 2012;40(4):406-11.
50. Zunker P, Happe S, Georgiadis AL, Louwen F, Georgiadis D, Ringelstein EB. Maternal cerebral hemodynamics in pregnancy-related hypertension. A prospective transcranial Doppler study. Ultrasound Obstet Gynecol. 2000 Aug; 16(2):179-87.
51. Williams KP, Moutquin JM. Do maternal cerebral vascular changes assessed by transcranial Doppler antedate pre-eclampsia?. Ultrasound Obstet Gynecol. 2004;23(3):254-6.
52. Martin JN, Blake PG, Perry KG, McCaul JF, Hess LW, Martin RW. The natural history of HELLP syndrome: patterns of disease progression and regression. Am J Obstet Gynecol. 1991;164(6 Pt 1):1500-9; discussion 9-13.
53. Williams KP, Wilson S. Maternal middle cerebral artery velocity changes in HELLP syndrome versus pre-eclampsia. Ultrasound Obstet Gynecol. 1998 Mar; 11(3):195-8.
54. Williams KP, Wilson S. Maternal cerebral blood flow changes associated with eclampsia. Am J Perinatol. 1995;12(3):189-91.
55. Belfort MA, Moise KJ Jr. Effect of magnesium sulfate on maternal brain flow in pre-eclampsia: a randomized, placebo-controlled study. Am J Obstet Gynecol. 1992 Sep; 167(3):661-6.
56. Naidu S, Payne AJ, Moodley J, Hoffmann M, Gouws E. Randomized study assessing the effect of phenytoin and magnesium sulphate on maternal cerebral circulation in eclampsia using transcranial Doppler ultrasound. Br J Obstet Gynaecol. 1996 Feb; 103(2):111-6.
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