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Transorbital Ultrasonographic Measurement of the Optic Nerve Sheath Diameter in Preeclampsia [24J]

INTRODUCTION: Preeclampsia is ranked as the second leading cause of maternal mortality worldwide, mostly due to acute cerebral complications. The objective of this study is to estimate the frequency of increased intracranial pressure (ICP) using transorbital ultrasound among pregnant women with and without preeclampsia. METHODS: Between September and October 2014, a cross-sectional study was conducted in a tertiary care hospital in Recife, Brazil. Ultrasonographic measurements of the optic nerve sheath diameter (ONSD), using a 10–12 MHz ultrasound linear probe, were performed in two groups: preeclamptic patients and non-preeclamptic pregnant women. Fisher's exact test was used to compare categorical data established to detect increased intracranial pressure between groups. RESULTS: A total of 33 cases were included in the study: 18 women with and 15 without preeclampsia with a mean (SD) age of 27.7 (7.4) and 23.3 (7.2) years respectively. The most frequent severe features in the patients with preeclampsia were: BP ≥160/110 mm Hg (100%), headache (22.2%) and focal neurologic signs (22.2%). Signs of elevated ICP were found in 27.7% of preeclamptic women, whereas none of the healthy ones had the ONSD measurement above 5 mm (value associated to detect ICP >20 cm H2O with a sensitivity of 88% and specificity of 93%). There was a statistically significant relation between increased ICP and preeclampsia (P<.05). CONCLUSION: Ultrasonographic measurement of the ONSD is a promising tool for the assessment of increased ICP and risk stratification in patients with preeclampsia. Further studies are necessary to substantiate the value of this non-invasive technique considering the possible neurologic complications in preeclampsia.