ABSTRACT

Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM.

BackgroundThere are no data on usefulness of optic nerve sheath diameter (ONSD) as a marker of patient’s fluid status in preeclampsia. The objective was to examine potential correlation between ONSD and lung ultrasound estimates of extravascular lung water in severe preeclampsia.Patients and methodsThirty patients with severe preeclampsia were included. Optic and lung ultrasound were performed within 24 hours from delivery. ONSD was measured 3 mm behind the globe. Lung ultrasound Echo Comet Score (ECS) was obtained summing B-lines (“comet tails”) in parasternal intercostal spaces bilaterally. Pearson’s correlation analysis was used to assess the relationship between ONSD and ECS (p < 0.05 significant).ResultsMedian ONSD was 5.7 mm (range 3.8–7.5 mm). Median ECS value was 19 (range 0-24). Statistically significant correlation was found between ONSD and ECS (r2 = 0.464; p < 0.001).ConclusionsSignificant correlation between ONSD and ECS suggests optic ultrasound could be used for assessing fluid status and guiding peripartum fluid therapy in patients with severe preeclampsia.

(Int J Obstet Anesth. 2018;36:49–55) In most patients (71% to 100%) with preeclampsia with severe features, signs of cerebral edema are present and confirmed by magnetic resonance imaging. Morbidity and mortality rates have been significantly improved when cerebral edema is promptly diagnosed and treated. Recently, ocular ultrasonography has been suggested to be a reliable means of detecting raised intracranial pressure (ICP) in nonpregnant populations. Specifically, optic nerve sheath diameter (ONSD) and optic disc height (ODH) as measured via ultrasound are increased in the setting of increased ICP. ONSD has been correlated to ICP measured invasively in nonpregnant patients. This study aimed to determine whether patients with preeclampsia with severe features have greater ONSD or ODH when compared with healthy pregnant women.

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