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Journal of Obstrectic Anaesthesia and Critical Care
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Year : 2019  |  Volume : 9  |  Issue : 2  |  Page : 65-69

Optic nerve sheath diameter measured using ocular sonography is raised in patients with eclampsia

1 Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
2 Department of Anaesthesiology and Critical Care, All India Institute of Medical Science, New Delhi, India

Correspondence Address:
Dr. Rajesh Kumar
Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak - 124 001, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joacc.JOACC_1_19

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Introduction: Eclampsia is one of the leading causes of maternal morbidity. Neurological sequelae are quite common and contribute to poor prognosis in these patients. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) as noninvasive monitor of raised intracranial pressure (ICP) might aid in management of these patients. Based on these facts, this study intended to study the difference between ONSD in eclampsia versus noneclamptic parturients admitted to intensive care unit (ICU). The trends in ONSD were followed in patients with eclampsia to assess the association between ONSD and resolution of neurological symptoms. Materials and Methods: The present observational study comprised 46 patients and was conducted in our ICU from January 2015 to June 2015. Postpartum eclamptic patients requiring ventilatory support in the ICU were enrolled in group E (n = 24), while postpartum patients admitted for some other causes but requiring ventilatory support were enrolled in group C (n = 22). Transorbital ultrasound was done to measure ONSD using SonoSite M-Turbo machine. It was repeated daily in both the groups till patients were extubated or expired. The vital parameters, treatment, and investigations were also noted. Results: The ONSD in group E was 0.64 ± 0.02 cm, while in group C it was 0.45 ± 0.03 cm (P < 0.0001). Blood pressure was much higher in group E (P < 0.001). ONSD had positive correlation with systolic blood pressure than diastolic blood pressure. In group E, 22 patients were extubated, and following extubation ONSD decreased to normal value in 16 patients while in 6 patients it was still raised. Overall mortality was 6 (13%); 2 (8.3%) in group E and 4 (18.2%) in group C. Conclusion: ONSD was higher in patients with eclampsia suggesting raised ICP, and with subsidence of disease process it decreased. Thus, it may be adopted as a routine monitoring in these patients to guide management and predict prognosis, although further studies are required to support our findings.

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