Opthalmic artery doppler measurements and cardiovascular assessment in pregnancies with placental dysfunction

Women affected by hypertensive disorders of pregnancy and fetal growth restriction frequently present alterations in the cardiovascular system, even before the clinical onset of the pathology. The objective of this study is to assess the relationship between peripheral vascular system (ophthalmic and uterine arteries), cardiac output and adverse fetomaternal outcomes.MethodsWomen with singleton pregnancies from mid second trimester until delivery were prospectively included in this observational study performed at our Hospital, between December 2020 and July 2021. The inclusion criteria included women with evidence of placental dysfunction (preeclampsia and fetal growth restriction) and normotensive controls.Vascular systemic resistance (VSR), arterial stiffness and cardiac output were measured by ultrasound (uterine and ophthalmic arteries), plethysmography and continuous Doppler. Study variables were compared using t-test and Chi-squared test according to whether they were normally distributed or not.ResultsThe analysis included 32% women with hypertensive disorders of pregnancy and 67% normal pregnancies.Statistically significant difference was observed in the Second to First Peak Systolic Velocity Ratio (2PSVR) of the ophthalmic artery (p=0.011), heart Rate (p=0.03), stroke volume (p=0.004) and cardiac output (0.094) between the two groups. There were significant correlation between parameters of the central haemodynamics and those of the uteroplacental circulation, as well as ophthalmic artery Doppler.ConclusionOphthalmic artery 2PSVR is a simple and potentially promising measurement to assess women with hypertensive disorders of pregnancy. However, this parameter must be validated against the well described Uterine artery Doppler. A bigger cohort is needed to clarify and determine its effectiveness.Funding AcknowledgementType of funding sources: Public grant(s) – EU funding. Main funding source(s): iPlacent