Cerebral haemodynamics in early puerperium: A prospective study

Journal article

Aim of the Study

Prospective study on 900 consecutive puerperae to assess normal values and range of the blood flow velocity in the middle cerebral artery (MCA) in both hemispheres.

Material and Method

M1 and M2 segments of both MCAs were assessed in all subjects within 96 hours of delivery. Mean flow velocity (MFV) was recorded after adjusting for insonation angle. Lindegaard index (LI= MCA- Internal Carotid Artery MFV ratio) was calculated whenever MFV exceeded 100 cm/sec. Asymmetry indexes (AIs) were calculated inter hemispherically for M1 and M2 segments separately

Results

MFVs were 74+17 and 72 +17 in right and 73+17 and 72+17 cm/sec in left M1 and M2 respectively. One-hundred thirty-six subjects (12.1%) exceeded the threshold of 100 cm/sec , but LI was consistently <3 in all of them . MFV was inversely and independently correlated to haemoglobin levels and to parity. Mean AIs were 0.25+23 in M1 and 0.45+25 in M2.

Conclusion

MFV in MCA of healthy subjects in early puerperium is higher than in age matched non puerperal women and may exceed the threshold of 100 cm/sec with no evidence of intracranial spasm, because of blood loss during delivery. MFV is independently correlated with parity. Right-to-left MFV asymmetry may reach 50% as a consequence of a transient imbalance in vascular tone regulation.

Authors: Anzola, G; Brighenti, R; Cobelli, M; Giossi, A; Mazzucco, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: SAGE Publications
• Journal: Ultrasound
• Volume: 25
• Issue: 2
• Pages: 107-114
• Publication date: 2017-01-29
• Acceptance date: 2017-01-08
• DOI: 10.1177/1742271X17690942
• EISSN: 1743-1344
• ISSN: 1742-271X
• Pmid: 28567105
• Language: English
• Keywords: puerperium; mean flow velocity; middle cerebral artery; asymmetry index