Effects of severe preeclampsia with different doppler velocimetries on extra- and intrauterine environments.

We evaluated the perinatal outcome of fetuses and maternal condition of 47 patients with severe preeclampsia. Antepartum fetal surveillance (within 2 days of delivery or fetal death) included the nonstress test, Doppler velocimetry of the umbilical and uterine arteries, amniotic fluid assessment, maternal blood chemistry and hemogram. Pregnancies with abnormal Doppler velocimetry in the umbilical and uterine arteries had poor perinatal outcomes as judged by the incidence of abnormal antepartum fetal surveillance, acute fetal distress mandating immediate delivery, small for gestational age infants, perinatal morbidity and mortality and prematurity. These fetuses were at a high risk of acute and chronic hypoxia. Maternal blood chemistries and hemograms revealed a high incidence of hepatocellular dysfunction, renal insufficiency, hemoconcentration and thrombocytopenia. In cases of severe preeclampsia, those with abnormal Doppler velocimetry of both umbilical and uterine arteries, had poor extra- and intrauterine environments. Therefore, aggressive rather than expectant management was more suitable. For those with normal umbilical artery resistance and either normal or abnormal uterine artery resistance, careful management with close monitoring of both maternal and fetal status was possible in patients who were far from term.