Abstract:
BACKGROUND AND OBJECTIVE
Preeclampsia (PE) is a lethal hypertensive disorder that significantly contributes
to maternal as well as fetal morbidity besides mortality, especially in low-resource settings like in India. Early diagnosis and management are crucial in
preventing adverse maternal and fetal outcomes. Preeclampsia causes
cerebrovascular endothelial dysfunction and impairs cerebral autoregulation due
to systemic hypertension. So, monitoring cerebrovascular alterations is crucial for
preventing severe neurological complications. In this study, we have used
maternal ophthalmic artery Doppler (OAD) as a key tool for monitoring
hemodynamic parameters and severity of the disease in preeclampsia and
normotensive pregnant women
METHODOLOGY
A prospective observational case-control study took place in a medical facility
that provided tertiary care from April 2023 to March 2025, including 170
pregnant women (85 preeclampsia cases and 85 normotensive controls). OAD
metrics, such as pulsatility index (PI), resistivity index (RI), peak systolic
velocity (PSV), and end-diastolic velocity (EDV), were measured using high-
resolution ultrasound with a 7-10MHz transducer. Data were analysed using
SPSS version 20, and cutoff values for determining preeclampsia severity were
determined using ROC curve analysis.
RESULTS
Preeclampsia patients demonstrated significantly higher RI and PI values
compared to controls(p=0.001). ROC analysis identified RI >0.72 and a strong
predictor of preeclampsia severity (sensitivity 82.3%, Specificity 79.4%).
Increased ophthalmic artery Doppler indices correlated with adverse maternal and
fetal consequences, including intrauterine growth restriction (IUGR) as well as
preterm birth.
CONCLUSION
This prospective observational case-control study demonstrates the maternal
ophthalmic artery doppler velocimetry as a valuable tool in evaluating and
predicting preeclampsia in pregnancy. Increased resistance in the right
ophthalmic artery and lower pulsatility suggest cerebrovascular dysfunction and
impaired autoregulation in pre-eclampsia. As it serves as a promising surrogate
marker for cerebrovascular dysfunction, its integration into routine obstetric
evaluation may aid in early detection and risk stratification.
