Ophthalmic artery Doppler as a measure of severe pre-eclampsia.

OBJECTIVE: To identify differences in orbital flow behavior in mild and severe pre-eclamptic women compared with healthy pregnant women, demonstrated by ophthalmic artery Doppler indexes. METHODS: Ophthalmic artery Doppler indexes of 20 mild and 20 severe pre-eclamptic women were compared with 51 healthy pregnant women. Right and left eye Doppler index means were evaluated and the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), end diastolic velocity (EDV), and peak ratio (PR) were calculated. RESULTS: Statistically significant differences were observed between PR, PSV, and EDV (P=0.0009, P=0.0020, P=0.0001) ophthalmic artery Doppler in a comparison of women with mild and severe pre-eclampsia. Statistically significant differences were seen between all Doppler indexes of the study group and healthy pregnant women. Ophthalmic PR, PSV, and EDV were significantly higher in severe pre-eclamptic cases but other index parameters did not show any difference. An elevation of diastolic and systolic flow occurred when pre-eclampsia became severe. CONCLUSION: Orbital vascular impedance reduction with orbital hyperperfusion was present in severe pre-eclamptic women compared with mild pre-eclamptic and healthy pregnant women. Ophthalmic Doppler is a novel parameter that may be useful in the diagnosis of severe pre-eclampsia.

[Role of urinary diversion in pyeloplasty (author's transl)]. / Le rôle de la dérivation urinaire dans la pyéloplastie.

A retrospective study was made of 105 pyeloplasties in 103 patients over a period of 18 years with the aim of precisely determining the role of urinary diversion in the post-operative period by nephrostomy tube and/or ureteral splint. A group of patients undergoing the same type of procedure, but without diversion, served as controls. Short-term results are evaluated clinically and radiologically and long-term results are evaluated by review of X-ray charts. These results were submitted to statistical analysis that have helped to demystify the role played aby diversion in pyeloplasties.

Pyeloplasty: to divert or not to divert?

The use of diversion in conjunction with pyeloplasty has been a matter of continuous debate for a number of years. In consequence the matter has been left to the urologist's individual preferences with no objective data to support these preferences. Herein the authors present an analysis of 105 pyeloplasties performed by four surgeons over a period of eighteen years with a view to determine the place and type of diversion in relation to the surgical technique used and the long-term effects of such diversion or abstinence thereof.