Variation of the Cerebral Flow Dynamics in Mexican Pregnant Women During the Third Trimester

Abstract

Background: Dynamic cerebral autoregulation and cerebral perfusion pressure are impaired in pregnancies complicated by preeclampsia compared with normotensive pregnancies, but the relationship between dynamic cerebral autoregulation and complications in preeclampsia remains a puzzle. Although it is well established that ethnicity, maternal age, and gestational age are among the risk factors for preeclampsia, the cerebral dynamics have been studied in different populations but not in the Mexican population. The aim of this study was to characterize the parameters of cerebral dynamics in the Mexican population according to gestational age and chronological age.

Methods: A prospective observational cross-sectional analytical study was carried out in Hospital Central Dr. Ignacio Morones Prieto, which included 68 healthy pregnant. Cerebral flow dynamics were measured by General Electric Logic P5 ultrasound equipment, and a 3SP multi-frequency sector transducer (1.5 - 3.5 MHz) was used, with right transtemporal pathway at the level of the temporal border on the upper base of the zygomatic arch in front and somewhat tragus, with a slight anterior angulation of the transducer (15 - 30). Middle cerebral artery was identified, and cerebral dynamics were measured.

Results: No statistically significant differences were found in peak mean diastolic or systolic velocities (peak diastolic cerebral blood flow velocity (PDCV) and peak systolic cerebral blood flow velocity (PSCV)) by chronological age groups. Significantly low cerebral perfusion pressure and systemic diastolic pressure were observed in patients ? 19 years. Patients with a gestational age of 32 - 36 weeks had significantly lower cerebral resistance index (2.3 0.9) and brain flow index (BFI, 14.0 6.6 cm/s) than patients with gestations ? 32 or ? 37 weeks. On the contrary, flow velocities were higher in 32 - 36 weeks compared to < 32 and > 37 weeks.

Conclusions: In Mexican pregnant women during the third trimester chronological age groups do not seem to influence cerebral dynamics in the third trimester, but there is an important difference observed at 32 - 36 weeks of gestation.

J Clin Gynecol Obstet. 2022;11(3):69-74
doi: https://doi.org/10.14740/jcgo801