Cerebral perfusion pressure and autoregulation in eclampsia
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Dynamic cerebral autoregulation and cerebral perfusion pressure are altered in preeclampsia compared to normotensive pregnancy.

This study was aimed to assess dynamic cerebral autoregulation and cerebral perfusion pressure after delivery in women with eclampsia, preeclampsia both with and without severe features, and in normotensive women.

Women were included at diagnosis (cases) or at admission for delivery (controls). Transcranial Doppler examinations with continuous non-invasive blood pressure measurements and end-tidal CO2 were conducted for cases and controls after delivery. Cerebral perfusion pressure and dynamic cerebral autoregulation index were calculated and values were compared between groups.

Researchers included 16 women with eclampsia, 18 women with preeclampsia with severe features, 32 women with preeclampsia without severe features, and 21 normotensive women with uncomplicated pregnancies.

--Dynamic cerebral autoregulation was depressed in women with eclampsia; compared to all other groups (preeclampsia with severe features, preeclampsia without severe features, and normotensive controls).

--Women with eclampsia had increased cerebral perfusion pressure compared to women with preeclampsia without severe features and normotensive pregnancy, while there was no difference in cerebral perfusion pressure between women with eclampsia and women with preeclampsia with severe features.

In particular, cerebral perfusion pressure, and in particular dynamic cerebral autoregulation, are altered in eclampsia and may be important in the pathophysiological pathway and in addition constitute a therapeutic target in the prevention of cerebral complications in preeclampsia.

American Journal of Obstetrics & Gynecology
Source: https://doi.org/10.1016/j.ajog.2021.03.017
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