Yasemin BİLGİLİ KARADENİZ, Zafer ONARAN, Pelin YILMAZBAŞ

Retrobulbar hemodynamics during healthy and preeclamptic pregnancy

Amaç: Sağlıklı ve preeklamptik gebelik sürecinde retrobulber hemodinamiklerin değerlendirilmesi amaçlanmıştır. Yöntemler: Yirmi bir sağlıklı gebe, 20 preeklamptik gebe ve 21 gebe olmayan doğurgan yaştaki kadın üzerinde retrobulber hemodinamikler çalışıldı. Oftalmik arter (OA), santral retinal arter (SRA) ve posterior siliyer arterin (PSA) tepe sistolik hızı, diastol sonu hızı ve rezistivite indeksleri (RI) renkli Doppler ile ölçüldü. Bulgular: Sistolik ve diastolik kan basınçları preeklamptik gebelerde (155±8.5 ve 105±7.5 mmHg, sırasıyla) sağlıklı gebelerdekine göre (110±5.5 ve 70±7.5 mmHg, sırasıyla, p=0.008) anlamlı düzeyde yüksek idi. OA, SRA ve PSA’da ölçülen RI değerleri sağlıklı gebelerde gebe olmayanlara göre belirgin şekilde düşük idi. Preeklamptik kadınlarda SRA ve PSA’nın RI değerleri sağlıklı gebe kadınlara göre anlamlı derecede yüksekti. Aradaki fark anlamlı olmasa da OA’nın RI’nın prekelamptiklerdeki değeri sağlıklı gebe kadınlardan daha düşük idi. Sonuç: Gebelik süresince tüm retrobulber arterlerde akıma karşı direnç azalmaktadır. Öte yandan preeklamptik gebelikte PSA ve SRA’da direncin artmasına karşın OA’da anlamlı olmayan bir düşüş saptanmıştır. Preeklamptik gebelikte hipertansiyona cevap olarak geliştirilen farklı otoregülasyon kontrol mekanizmaları orbitanın farklı boyuttaki arterlerinin farklı iletiminden sorumlu olabilir. (Gazi Med J 2012; 23: 55-8)

Sağlıklı ve preeklamptik gebelikte retrobulber hemodinamikler

Objective: We aimed to evaluate retrobulbar hemodynamics during healthy and preeclamptic pregnancy. Methods: We studied retrobulbar hemodynamics in 21 healthy pregnant, 20 preeclamptic and 21 non-pregnant fertile women. The peak systolic velocity, end-diastolic velocity and resistivity index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by color Doppler imaging. Results: The systolic and diastolic blood pressures of the preeclamptic women (155±8.5 and 105±7.5 mmHg, respectively) were significantly higher than those of healthy pregnant women (110±5.5 and 70±7.5 mmHg, respectively, p=0.008). The RI values of OA, CRA and PCA in healthy pregnant women were significantly lower than those of the non-pregnant women. The RI of the CRA and PCA in preeclamptic women were significantly higher than those of healthy pregnant women. Although there was no statistical significant difference, the RI of the OA was lower in preeclamptic women than healthy pregnant women. Conclusion: Resistance of all retrobulbar arteries decreased during healthy pregnancy. On the other hand, increased resistance was detected in PCA and CRA, besides the nonsignificant decrease in OA during preeclamptic pregnancy. Different auto regulator control mechanisms in response to hypertension seem to be responsible for the different conducts of different sized arteries of orbita during preeclamptic pregnancy. (Gazi Med J 2012; 23: 55-8)

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