Chronic perfusion changes and reduction in preeclampsia incidence in pregnant smokers: an ophthalmic artery Doppler study

Objective: Our aim was to investigate the hemodynamic profile of the ophthalmic artery in preeclamptic women, pregnant smokers and pregnant controls with no known diseases. Study design: A prospective cross-sectional study using the performed ophthalmic artery Doppler ultrasonography in 20 mild preeclamptic women and 20 severe preeclamptic women, 37 pregnant smokers and 51 controls. Data evaluated by using Doppler ultrasonography were as follows: resistance index, pulsatility index, peak systolic velocity, end diastolic velocity, second peak systolic velocity and peak ratio. The Doppler results, gestational age, patient age and systolic and diastolic pressure of groups were subjected to analysis of variance (p < 0.05). Results: Both groups of preeclamptic women presented significant orbital hyperperfusion (resistance index: 0.64 +/- 0.07 and 0.64 +/- 0.13, pulsatility index: 1.10 +/- 0.26 and 1.02 +/- 0.30, end diastolic velocity: 14.13 +/- 4.44 and 15.66 +/- 4.17), whereas pregnant smokers showed vasospasm (0.84 +/- 0.04, 2.27 +/- 0.43, 4.78 +/- 1.28, respectively) indicating divergent vascular pattern between these two groups (p < 0.01) and differences between each group and controls (0.78 +/- 0.06, 1.89 +/- 0.36, 7.43 +/- 2.71), respectively, p < 0.01. Peak systolic velocity mean values for severe preeclamptic women was 40.36 +/- 5.61 cm/s, significantly higher than in all groups (34.53 +/- 6.82 cm/s, 31.03 +/- 4.72 cm/s and 34.35 +/- 6.43 cm/s). Conclusion: Preeclamptic women have presented hyperperfusion whereas chronic smokers have shown hypoperfusion in ophthalmic artery. Thus, chronic flow changes in pregnant smokers might reduce the number of sudden and catastrophic events in preeclampsia.