ABSTRACT

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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Purpose: Cervical traumas are frequent in emergency department and X-ray, CT, and MRI are the essential imaging modalities in the diagnosis. However, especially for pregnant and morbid obese patients and children, these techniques can be challenging. We tested the success of point-of-care ultrasound in the evaluation of cervical traumas. Methods: This is a case series of cervical vertebra imaging with ultrasound in emergency department. We used linear probe and placed it anterolaterally to the neck, parallel to cervical spine. Images were obtained by an ultrasound-certified emergency physician. The height of the anterior wall of vertebral body, irregularity in vertebral body, and intervertebral space were assessed. Results: We presented a case series of six patients. Ultrasound images of cervical vertebral bodies and intervertebral spaces were able to obtain for all the patients. Any pathology was not observed in ultrasound imaging. This finding was compatible with cervical X-ray and CT scans and all the patients were discharged. Conclusions: However, this is a case series report of minor cervical trauma, and we were able to obtain ultrasound images of cervical vertebra bodies with point-of-care ultrasound examination by an emergency physician. This technique can be important for the patients contraindicated to CT or MRI. Also, it can give additional information to X-ray and CT scans especially for soft tissues. A2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasound