Determining the effect of Magnesium Sulfate on Doppler Parameters of Fetal Umbilical and Middle Cerebral Arteries in Women with Severe Preeclampsia: A Prospective Study

Abstract

Background: Preeclampsia is best described as a pregnancy-specific syndrome that can affect every organ system. Although preeclampsia is much more than simply gestational hypertension with proteinuria, appearance of proteinuria remains an important objective diagnostic criterion. The aim of this study is to evaluate Doppler velocimetric parameters (resistance index [RI], pulsatility index [PI], and systolic/diastolic [S/D] ratio) of the umbilical and middle cerebral arteries before and after magnesium sulfate administration in pregnant women with severe preeclampsia. Methods: This prospective study had been included 25 women from the emergency department and Obstetrics outpatient clinic Tanta University. Resistance index [RI], pulsatility index [PI] and systolic/ diastolic [S/D] ratio of middle cerebral artery and umbilical artery before and 20 minutes after intravenous administration of 6 grams of magnesium sulfate (loading dose). Results: The maternal age of cases included in the study ranged between 18 year and 40 year with a mean age of 32.03±6.1. The gravidity of cases included in the study ranged between 1 and 5 with a mean of 2.01±1.03.The parity of cases included in the study ranged between 0 and 6 with a mean of 2.18±1.04.The number of abortions ranged between 0 and 3whith a mean of 0.61±0.03. The serum level of ALT ranged between 11 and 104 mEq/L with a mean of 49.12±27.81. The serum level of AST ranged between 13 and 84 mEq/L with a mean of 42.5±20.17. The resistance index (RI) before MgSo4 administration ranged between 0.45 and 1.0 with a mean of 0.65 ± 0.15while it ranged between 0.4 and 0.9 after MgSo4 administration with a mean of 0.63± 0.13 .There was statistical significant differences between them (p<0.001). The pulsatility index (PI) before MgSo4 administration ranged between 0.6 and 2.15 with a mean of 1.15±0.45 while it ranged between 0.5 and 0.2 after MgSo4 administration with a mean of 1.04± 0.45 .There was statistical significant differences between them (p<0.001) . Conclusions: Infusion of MgSO4 significantly decreases the fetal RI-umbilical and PI-MCA and increases C/U ratio indices obtained with color Doppler ultrasound evaluations.