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Abstract
Background and Aims Ocular ultrasonography is a noninvasive method to detect intracranial hypertension through the measurement of the optic nerve sheath diameter (ONSD). Higher diameters have been reported in preeclampsia and eclampsia, but it is not known if this finding is associated with adverse maternal and neonatal outcomes. This study aimed to determine whether there is an association between the hypertensive syndromes of pregnancy and ONSD or between this measurement and adverse maternal and neonatal outcomes.
Methods Cohort study with 183 pregnant women in the third trimester and puerperal women up to 24 hours after delivery, with the following final distribution: control group (30), gestational hypertension (14), chronic hypertension (12), preeclampsia without severe features (12), preeclampsia with severe features (62), superimposed preeclampsia (23) and eclampsia (30). Ocular ultrasonography was performed. Pregnancy data and outcomes were collected by chart review.
Results The ONSD was not significantly different between hypertensive syndromes and controls (p=0.056). Larger diameters were associated with maternal Intensive Care Unit (ICU) admission (p=0.00002) and maternal near miss (p=0.05). There was no association between ONSD and neonatal ICU admission (p=0.1), neonatal near miss (p=0.34), or neonatal death (p=0.26). Diameters greater than 5mm were associated with headache (p=0.008), maternal ICU admission (p<0.01), delivery with a gestational age of less than 34 weeks (p=0.01), and a newborn Apgar score below seven in the first minute of life (p=0.009).
Ultrasonographic measurement of the optic nerve sheath diameter
Distribution of optic nerve sheath diameters
Conclusions There were no significant differences in ONSD between the hypertensive syndromes of pregnancy and controls without hypertension. Larger diameters were associated with maternal ICU admission and maternal near miss.