Maternal cerebral blood flow and glucose metabolism in pregnancies complicated by severe preeclampsia

Objective. To investigate maternal cerebral blood flow and glucose metabolism in pregnancies complicated by severe preeclampsia compared to normal pregnancies. Methods. A prospective study was conducted including six women with severe preeclampsia and nine normotensive women. Transcranial Doppler (TCD) was performed pre- and postoperatively. The anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA) were selected for study; the cerebral perfusion pressure (CPP) and cerebral flow index (CFI) were calculated for each vessel. To evaluate the cerebral glucose metabolism, F-18 fluorodeoxyglucose positron emission tomography was performed postoperatively. Results. The preoperative CFI in each artery was similar in the comparisons between the two groups. However, the CPP in the MCA and the PCA was higher in the patients with severe preeclampsia. Compared to the preoperative values, the postoperative CPP and CFI in the ACA and the MCA were significantly increased in the severe preeclampsia group, while they were significantly decreased in the control group. Overall, the regional cerebral glucose uptake was not significantly different in comparisons between the two groups. In addition, there was no correlation between the cerebral Doppler indices and their corresponding regional cerebral glucose uptake. Conclusions. Severe preeclampsia was associated with an increase in the cerebral blood flow and perfusion pressure, particularly during the postpartum period, but it was not associated with a significant change in the cerebral glucose metabolism.