Pravastatin improves placental perfusion and decreases umbilical artery vascular resistance in patients with increased umbilical artery pulsatility index
Aleksandar Jurisic (RS), Zaklina Jurisic (RS), Svetlana Dragojevic Dikic (RS)
[Jurisic] University of Belgrade Medical School, Narodni front OB/GYN Univ. Hospital, [Jurisic] OB/GYN Polyclinic "Jurisic", [Dragojevic Dikic] University of Belgrade Medical School, Narodni front OB/GYN Univ. Hospital
Objective: Analysis of therapeutic effects of pravastatin on improvement of placental perfusion and decrease of umbilical artery vascular resistance in patients with increased umbilical artery pulsatility index for gestational age. Methods In this study 6 patients, where isolated increased umbilical vascular resistance with normal uterine artery doppler findings, were included. Pravastatin was administered to all patients between 21-25th week, when umbilical artery pulsatility index was above limits for gestational age. Patients were scanned in 2-4 week interval to follow up changes in vascular resistance in umbilical artery. Results: Two patients had dichorionic twin pregnancy where ischemic placental disease occurred in one fetus. Other four patients has singleton pregnancy. In patients with twin pregnancy Pravacor therapy was introduced when AEDV appeared in umbilical artery. Blood flow improved and we managed to extend pregnancy until 34 week. Cardiotocographic findings were normal in both fetuses without signs of asphyxia until delivery. In another 4 patients Pravastatin was introduced when PI values were above normal limits for gestational age. Umbilical artery PI values were decreased up to normal range and remained normal until term delivery. .All neonates were born without signs of intrauterine asphyxia. Conclusion: In patients with isolated increased umbilical artery vascular resistance, with normal uterine artery vascular resistance, increased placental perfusion and decreased vascular resistance in umbilical arteries was achieved after administration of Pravastatin. Administration of Pravastatin reduced the incidence of early premature delivery due to fetal asphyxia.