Hippokratia 2006; 10 (3): 133-137
M Lubomirova, E Andreev, B Bogov, R Djerassi, B Kiperova, A Nikolov, V Stoykova, V Diavolov, A Dimitrov
Clinic of Nephrology, Medical University Hospital "Alexandrovska", Sofia, Bulgaria
Background. Preeclampsia (PE) is a pregnancy complication usually of the third trimester. The clinical manifestations are hypertension and proteinuria with or without edema. Its pathogenesis is characterized by generalized vasoconstriction and endothelial dysfunction. The aim of this study was to evaluate the diagnostic value of the Doppler ultrasound examination of the renal interlobar vessels in pregnancy complicated with preeclampsia in the context of the theory about the increased vessel resistance in this pregnancy disorder.
Methods. Fifty two women aged 16-38, (mean age 23??9.54) streamed into three groups were examined by abdominal ultrasound in Triplex regime. The first group included 18 pregnant with PE, the second 21 women in the third trimester of normal pregnancy, and the third group 13 non-pregnant women. In all 3 groups the renal volume (RV) and parenchyma volume (PV) were determined by conventional ultrasound (CU). The doppler waveform analysis (DWA) of the interlobar renal arteries (IRA) gave the following indices: resistance index (RI), pulsatility index (PI), peak systolic velocity (Vmax) and end diastolic velocity (Vmin).
Results. RV and PV in the PE group were significantly higher than those of the healthy pregnant women: RV: 231.4??58 to 187??45, p < 0.05 and for PV: 200??11 to 130??6.78, p < 0.05. Such a difference was not found out for the healthy pregnant women compared to the non-pregnant ones. No significant differences of the examined doppler indices were found in the three groups.
Conclusion. Although the arteriolar vasoconstriction and the tissue hypoxia are leading in the PE pathogenesis, the DWA of the IRA in PE pregnancy does not differ from those of the healthy pregnant and nonpregnant women. As one of the most frequently used imaging technique Doppler Ultrasou (DU) of the renal IRA and DWA of these vessels shows no diagnostic advantage as compared to the renal CU in pregnancy complicated with PE.
Keywords: preeclampsia, pregnancy, vasoconstriction, conventional and doppler ultrasound