PP072. Features of intrarenal blood flow in patients with preeclampsia (PE).

Introduction: The pregnancy-associated complication preeclampsia is a leading cause of maternal and fetal morbidity and mortality. The classical clinical manifestations of preeclampsia are elevated blood pressure and proteinuria due to renal damage. In severe cases of preeclampsia, the only effective treatment is delivery, irrespective of gestational age.

Objectives: To investigate renal perfusion in PE patients by ultrasound Doppler examination and to assess the possibility of strategy to identify renal blood flow changes to predict preeclampsia before the onset of disease.

Methods: We studied 31 pregnant women of 21-46 years without renal disease: 19 PE (gr.1) and 12 volunteers (gr.2 ). PE was defined as a combination of proteinuria >0.3g/24h and blood pressure >140/90mmHg. We used Vivid7. We measured systolic (Vps), diastolic (Ved) velocities in renal and segmental arteries, and in at 5 pulse beats of interlobar and arcuate arteries. The resistance parameter (RI)=(Vps-Ved )/Vps.

Results: Table 1. The intrarenal blood flow in distal arteries. There was no difference in velocities and RI in renal and segmental arteries in both groups. We noted decrease of arterial and increase of the venous flow (color Doppler) of distal arteries in gr.1 seems to be a marker of renal ischaemia. All volunteers have the same parameters from signals of all pulse beats in one area - in arcuate and interlobar arteries. The RI in gr.1 varied in all distal arteries pulse beats in comparison with gr.2, where RI was identical.

Conclusion: The "patchy" decreasing of RI suggests the presence of thromo-occlusive lesions leading to arteriovenous blood flow bypassing. The doppler ultrasonography may be used as a method of early diagnostic PE.