Laser-doppler flowmetry Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women.
From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor.
The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester.
According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women.
From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor.
The mean age of cases was 26.4±5.11. The uterine artery PI and RI values for both second (PI: 1.1±0.42 versus 1.53±0.59, p=0.002; RI: 0.55±0.09 versus 0.72±0.13, p=0.000 respectively) and third-trimester (PI: 0.77±0.31 versus 1.09±0.46, p=0.000; RI: 0.46±0.10 versus 0.60±0.14, p=0.010 respectively) evaluations were significantly higher in patients with adverse pregnancy outcome than in normal women. Combination of PI and RI >95th percentile and presence of bilateral notch in second trimester get sensitivity and specificity of 36.1 and 97% respectively, while these measures were 57.5 and 98.2% in third trimester.
According to our study, it seems that uterine artery Doppler may be a valuable tool for the prediction of a variety of adverse outcomes in second and third trimesters.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
O objetivo do presente estudo longitudinal foi avaliar o valor da ultrassonografia Doppler das artérias uterinas no segundo e terceiro trimestres de gestação para a predição de desfecho adverso da gravidez em mulheres de baixo risco.
De julho de 2011 até agosto de 2012, 205 gestantes de feto único atendidas em nossa clínica de pré-natal foram incluídas no presente estudo prospectivo e avaliadas em termos de dados demográficos e obstétricos. As pacientes foram submetidas à avaliação de ultrassom durante o segundo e terceiro trimestres, incluindo avaliação Doppler das artérias uterinas bilaterais, visando determinar os valores do índice de pulsatilidade (IP) e do índice de resistência (IR), bem como a presença de incisura diastólica precoce. O desfecho do presente estudo foi a avaliação da sensibilidade, especificidade, valor preditivo positivo (VPP) e valor negativo preditivo (VNP) da ultrassonografia Doppler das artérias uterinas para a predição de desfechos adversos da gravidez, incluindo pré-eclâmpsia, natimortalidade, descolamento prematuro da placenta e trabalho de parto prematuro.
A média de idade das gestantes foi de 26,4±5,11 anos. Os valores de IP e IR das artérias uterinas para o primeiro (IP: 1,1±0,42 versus 1,53±0,59, p=0,002; IR: 0,55±0,09 versus 0.72±0.13, p=0,000, respectivamente) e para o terceiro trimestre (IP: 0,77±0,31 versus 1,09±0,46, p=0,000; IR: 0,46±0,10 versus 0,60±0,14, p=0,010, respectivamente) foram significativamente maiores em pacientes com desfecho adverso da gravidez em relação às mulheres com desfecho normal. A combinação de IP e IR > percentil 95 e a presença de incisura bilateral apresentou sensibilidade e especificidade de 36,1 e 97%, respectivamente, no segundo trimestre e de 57,5 e 98,2% no terceiro trimestre.
Com base no presente estudo, o Doppler das artérias uterinas parece ser ferramenta valiosa para a predição de uma variedade de desfechos adversos no segundo e terceiro trimestres de gestação.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):35-39
DOI 10.1590/S0100-72032014000100008
O objetivo do presente estudo longitudinal foi avaliar o valor da ultrassonografia Doppler das artérias uterinas no segundo e terceiro trimestres de gestação para a predição de desfecho adverso da gravidez em mulheres de baixo risco.
De julho de 2011 até agosto de 2012, 205 gestantes de feto único atendidas em nossa clínica de pré-natal foram incluídas no presente estudo prospectivo e avaliadas em termos de dados demográficos e obstétricos. As pacientes foram submetidas à avaliação de ultrassom durante o segundo e terceiro trimestres, incluindo avaliação Doppler das artérias uterinas bilaterais, visando determinar os valores do índice de pulsatilidade (IP) e do índice de resistência (IR), bem como a presença de incisura diastólica precoce. O desfecho do presente estudo foi a avaliação da sensibilidade, especificidade, valor preditivo positivo (VPP) e valor negativo preditivo (VNP) da ultrassonografia Doppler das artérias uterinas para a predição de desfechos adversos da gravidez, incluindo pré-eclâmpsia, natimortalidade, descolamento prematuro da placenta e trabalho de parto prematuro.
A média de idade das gestantes foi de 26,4±5,11 anos. Os valores de IP e IR das artérias uterinas para o primeiro (IP: 1,1±0,42 versus 1,53±0,59, p=0,002; IR: 0,55±0,09 versus 0.72±0.13, p=0,000, respectivamente) e para o terceiro trimestre (IP: 0,77±0,31 versus 1,09±0,46, p=0,000; IR: 0,46±0,10 versus 0,60±0,14, p=0,010, respectivamente) foram significativamente maiores em pacientes com desfecho adverso da gravidez em relação às mulheres com desfecho normal. A combinação de IP e IR > percentil 95 e a presença de incisura bilateral apresentou sensibilidade e especificidade de 36,1 e 97%, respectivamente, no segundo trimestre e de 57,5 e 98,2% no terceiro trimestre.
Com base no presente estudo, o Doppler das artérias uterinas parece ser ferramenta valiosa para a predição de uma variedade de desfechos adversos no segundo e terceiro trimestres de gestação.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):33-38
DOI 10.1590/S0100-72032013000100007
PURPOSE: To create longitudinal reference intervals for pulsatility index (PI) of the umbilical (UA), middle cerebral (MCA), uterine (UtA) arteries and ductus venosus (DV) in a Brazilian cohort. METHODS: A longitudinal observational study performed from February 2010 to May 2012. Low risk pregnancies were scanned fortnightly from 18 to 40 weeks for the measurements of PI of the UA, MCA, DV and UtA. Linear mixed models were used for the elaboration of longitudinal reference intervals (5th, 50th and 95th percentiles) of these measurements. PI obtained for the placental and abdominal portions of the umbilical artery were compared by the t-test for independent samples. Two-sided p values of less than 0.05 were considered statistically significant. RESULTS: A total of 164 patients underwent 1,242 scans. There was significant decrease in PI values of all vessels studied with gestational age (GA). From the 18th to the 40th week of pregnancy, the median PI values of UA (abdominal and placental ends of the cord), MCA, DV and the mean PI of the UtA ranged from 1.19 to 0.74, 1.33 to 0.78, 1.56 to 1.39, 0.58 to 0.41, and 0.98 to 0.66, respectively. The following equations were obtained for the prediction of the medians: PI-UA=1.5602786 - (0.020623 x GA); Logarithm of the PI-MCA=0.8149111 - (0.004168 x GA) - [0.02543 x (GA - 28.7756)²]; Logarithm of the PI-DV=-0.26691- (0.015414 x GA); PI-UtA = 1.2362403 - (0.014392 x GA). There was a significant difference between the PI-UA obtained at the abdominal and placental ends of the umbilical cord (p<0.001). CONCLUSIONS: Longitudinal reference intervals for the main gestational Doppler parameters were obtained in a Brazilian cohort. These intervals could be more adequate for the follow-up of maternal-fetal hemodynamic modifications in normal and abnormal pregnancies, a fact that still requires further validation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):33-38
DOI 10.1590/S0100-72032013000100007
PURPOSE: To create longitudinal reference intervals for pulsatility index (PI) of the umbilical (UA), middle cerebral (MCA), uterine (UtA) arteries and ductus venosus (DV) in a Brazilian cohort. METHODS: A longitudinal observational study performed from February 2010 to May 2012. Low risk pregnancies were scanned fortnightly from 18 to 40 weeks for the measurements of PI of the UA, MCA, DV and UtA. Linear mixed models were used for the elaboration of longitudinal reference intervals (5th, 50th and 95th percentiles) of these measurements. PI obtained for the placental and abdominal portions of the umbilical artery were compared by the t-test for independent samples. Two-sided p values of less than 0.05 were considered statistically significant. RESULTS: A total of 164 patients underwent 1,242 scans. There was significant decrease in PI values of all vessels studied with gestational age (GA). From the 18th to the 40th week of pregnancy, the median PI values of UA (abdominal and placental ends of the cord), MCA, DV and the mean PI of the UtA ranged from 1.19 to 0.74, 1.33 to 0.78, 1.56 to 1.39, 0.58 to 0.41, and 0.98 to 0.66, respectively. The following equations were obtained for the prediction of the medians: PI-UA=1.5602786 - (0.020623 x GA); Logarithm of the PI-MCA=0.8149111 - (0.004168 x GA) - [0.02543 x (GA - 28.7756)²]; Logarithm of the PI-DV=-0.26691- (0.015414 x GA); PI-UtA = 1.2362403 - (0.014392 x GA). There was a significant difference between the PI-UA obtained at the abdominal and placental ends of the umbilical cord (p<0.001). CONCLUSIONS: Longitudinal reference intervals for the main gestational Doppler parameters were obtained in a Brazilian cohort. These intervals could be more adequate for the follow-up of maternal-fetal hemodynamic modifications in normal and abnormal pregnancies, a fact that still requires further validation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(12):584-590
DOI 10.1590/S0100-72032010001200004
PURPOSE: to evaluate the differences between the maternal and perinatal outcomes of pregnancies complicated by preeclampsia, according to the classification as the severe/mild form, and the early/late onset form. METHODS: a retrospective study with 211 pregnancies complicated by preeclampsia, assessed at a university reference center from 2000 to 2010. The diagnosis and disease severity were based on the values of blood pressure, proteinuria, and clinical and laboratory findings. The pregnant's age, skin color, parity, blood pressure, urine protein semiquantitative values, presence of bilateral notch in the uterine artery dopplervelocimetry and birth conditions were compared between patients with mild and severe disease, as well as between those of early/late onset. The disease was considered to be of early onset when diagnosed at less than 34 weeks of gestational age. RESULTS: most patients had the severe form of preeclampsia (82.8%), and the onset of the condition was early in 50.7%. Blood pressure values (133.6±14.8 versus 115.4 mmHg, p=0.0004 and 132.2±16.5 versus 125.7 mmHg, p=0.0004) and semiquantitative proteinuria (p=0.0003 and p=0.0005) were higher in the early and severe forms compared to mild and late forms. Infant birth weight (1,435.4±521.6 versus 2,710±605.0 g, 1,923.7±807.9 versus 2,415.0±925.0 g, p<0.0001 for both) and Apgar score (p=0.01 for both) were smaller for severe and early preeclampsia compared to mild and late preeclampsia. On the other hand, the presence of a bilateral notch in the uterine arteries was linked to the forms of early onset (69.2 versus 47.9%, p=0.02), whereas fetal growth restriction was more frequent in the severe forms of preeclampsia (30 versus 4.4%, p=0.008). CONCLUSION: the preeclampsia classification based on maternal clinical parameters better reflected the conditions of fetal nutrition, while the early onset of the condition was associated with placental vasculopathy detected by dopplervelocimetry.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(12):584-590
DOI 10.1590/S0100-72032010001200004
PURPOSE: to evaluate the differences between the maternal and perinatal outcomes of pregnancies complicated by preeclampsia, according to the classification as the severe/mild form, and the early/late onset form. METHODS: a retrospective study with 211 pregnancies complicated by preeclampsia, assessed at a university reference center from 2000 to 2010. The diagnosis and disease severity were based on the values of blood pressure, proteinuria, and clinical and laboratory findings. The pregnant's age, skin color, parity, blood pressure, urine protein semiquantitative values, presence of bilateral notch in the uterine artery dopplervelocimetry and birth conditions were compared between patients with mild and severe disease, as well as between those of early/late onset. The disease was considered to be of early onset when diagnosed at less than 34 weeks of gestational age. RESULTS: most patients had the severe form of preeclampsia (82.8%), and the onset of the condition was early in 50.7%. Blood pressure values (133.6±14.8 versus 115.4 mmHg, p=0.0004 and 132.2±16.5 versus 125.7 mmHg, p=0.0004) and semiquantitative proteinuria (p=0.0003 and p=0.0005) were higher in the early and severe forms compared to mild and late forms. Infant birth weight (1,435.4±521.6 versus 2,710±605.0 g, 1,923.7±807.9 versus 2,415.0±925.0 g, p<0.0001 for both) and Apgar score (p=0.01 for both) were smaller for severe and early preeclampsia compared to mild and late preeclampsia. On the other hand, the presence of a bilateral notch in the uterine arteries was linked to the forms of early onset (69.2 versus 47.9%, p=0.02), whereas fetal growth restriction was more frequent in the severe forms of preeclampsia (30 versus 4.4%, p=0.008). CONCLUSION: the preeclampsia classification based on maternal clinical parameters better reflected the conditions of fetal nutrition, while the early onset of the condition was associated with placental vasculopathy detected by dopplervelocimetry.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):366-371
DOI 10.1590/S0100-72032008000700008
The application and development of obstetric Dopplervelocimetry provide a basis for the investigation of placental insufficiency and demonstrate the dynamic behavior of fetal circulation during hypoxia. In clinical practice, assessing hemodynamics in three vascular regions involved in pregnancy, namely the uterine, umbilical and middle cerebral arteries, has become routine. Roughly, the cerebral artery expresses the balance between uterine artery oxygen supply and umbilical artery oxygen uptake. Currently, when such balance is unfavorable, the fetal cardiac reserve is investigated by assessing the venous duct. However, determining and interpreting vascular resistance indexes is not an easy task. The starting point is to know the physiopathology of placental insufficiency and fetal circulatory adaptation through which Doppler confirmed its role in the assessment of fetal well-being.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(7):366-371
DOI 10.1590/S0100-72032008000700008
The application and development of obstetric Dopplervelocimetry provide a basis for the investigation of placental insufficiency and demonstrate the dynamic behavior of fetal circulation during hypoxia. In clinical practice, assessing hemodynamics in three vascular regions involved in pregnancy, namely the uterine, umbilical and middle cerebral arteries, has become routine. Roughly, the cerebral artery expresses the balance between uterine artery oxygen supply and umbilical artery oxygen uptake. Currently, when such balance is unfavorable, the fetal cardiac reserve is investigated by assessing the venous duct. However, determining and interpreting vascular resistance indexes is not an easy task. The starting point is to know the physiopathology of placental insufficiency and fetal circulatory adaptation through which Doppler confirmed its role in the assessment of fetal well-being.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(11):534-539
DOI 10.1590/S0100-72032009001100002
PURPOSE: to analyze the ophthalmic artery functioning in pregnant women with systemic lupus erythematosus (PL) without active renal disease as compared to non-pregnant women with lupus (NPL) without active renal disease, and to normal pregnant women (PN). METHODS: observational study that analyzed ophthalmic artery dopplervelocimetric variables of 20 PN, 10 PL and 17 NPL women. The variables analyzed were: pulsatility index (PI), final diastolic velocity (FDV) and velocity peak ratio (VPR). Mean and standard deviation of these indexes were calculated. For group mean comparison, analysis of variance (ANOVA) and the post-hoc Tukey test have been used, with confidence interval of 95% (p<0.05). RESULTS: the PN group showed the following means and standard deviations of ophthalmic artery parameters: PI=2,4±0,3; VPR=0,5±0,1 e FDV=5,1±2,1 cm/s. The PL and NPL groups showed the following values, respectively: PI=2,0±0,4 and 1,9±0,4; VPR=0,6±0,1 and 0,6±0,1; FDV=9,7±3,9 cm/s and 8,1±4,3 cm/s. There was not significant mean difference between the PL and NPL groups for PI, VPR or FDV. However, statistically significant mean differences were observed between PN and PL for PI, VPR and FDV, with higher values of FDV and VPR in the PL group. CONCLUSIONS: there was a reduction of ophthalmic artery vascular impedance with orbital hyperfusion in the two groups of women with lupus erythematosus as compared to normal pregnant women. These results may help to improve the understanding on pathophysiology of systemic lupus erythematosus. In addition, the present method may be applied in future studies as a complementary procedure for the differential diagnosis between pre-eclampsia and renal failure due to lupus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(11):534-539
DOI 10.1590/S0100-72032009001100002
PURPOSE: to analyze the ophthalmic artery functioning in pregnant women with systemic lupus erythematosus (PL) without active renal disease as compared to non-pregnant women with lupus (NPL) without active renal disease, and to normal pregnant women (PN). METHODS: observational study that analyzed ophthalmic artery dopplervelocimetric variables of 20 PN, 10 PL and 17 NPL women. The variables analyzed were: pulsatility index (PI), final diastolic velocity (FDV) and velocity peak ratio (VPR). Mean and standard deviation of these indexes were calculated. For group mean comparison, analysis of variance (ANOVA) and the post-hoc Tukey test have been used, with confidence interval of 95% (p<0.05). RESULTS: the PN group showed the following means and standard deviations of ophthalmic artery parameters: PI=2,4±0,3; VPR=0,5±0,1 e FDV=5,1±2,1 cm/s. The PL and NPL groups showed the following values, respectively: PI=2,0±0,4 and 1,9±0,4; VPR=0,6±0,1 and 0,6±0,1; FDV=9,7±3,9 cm/s and 8,1±4,3 cm/s. There was not significant mean difference between the PL and NPL groups for PI, VPR or FDV. However, statistically significant mean differences were observed between PN and PL for PI, VPR and FDV, with higher values of FDV and VPR in the PL group. CONCLUSIONS: there was a reduction of ophthalmic artery vascular impedance with orbital hyperfusion in the two groups of women with lupus erythematosus as compared to normal pregnant women. These results may help to improve the understanding on pathophysiology of systemic lupus erythematosus. In addition, the present method may be applied in future studies as a complementary procedure for the differential diagnosis between pre-eclampsia and renal failure due to lupus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):537-543
DOI 10.1590/S0100-72032008001100002
PURPOSE: to evaluate the effect of tibolone use on dopplervelocimetric parameters of ophthalmic and retinal arteries. METHODS: clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. RESULTS: in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71±0.05, RI(post)0.72±0.08 (p=0.43); PI(pre)=1.29±0.22, PI(post)=1.30±0.25 (p=0.4) and S/D(pre)=3.49±0.77, SD(post)=3.65±0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67±0.09, RI(post)=0.69±0.10 (p=0.7); PI(pre)=1.20±0.29, PI(post)=1.22±0.3 (p=0.2) and SD(pre)=3.29±0.95, SD(post)=3.30±1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. CONCLUSIONS: the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):537-543
DOI 10.1590/S0100-72032008001100002
PURPOSE: to evaluate the effect of tibolone use on dopplervelocimetric parameters of ophthalmic and retinal arteries. METHODS: clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. RESULTS: in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71±0.05, RI(post)0.72±0.08 (p=0.43); PI(pre)=1.29±0.22, PI(post)=1.30±0.25 (p=0.4) and S/D(pre)=3.49±0.77, SD(post)=3.65±0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67±0.09, RI(post)=0.69±0.10 (p=0.7); PI(pre)=1.20±0.29, PI(post)=1.22±0.3 (p=0.2) and SD(pre)=3.29±0.95, SD(post)=3.30±1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. CONCLUSIONS: the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.