Document Detail

Optic nerve sheath diameter used as ultrasonographic assessment of the incidence of raised intracranial pressure in preeclampsia: a pilot study.
MedLine Citation:
PMID:  22258019     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In some cases of severe preeclampsia/eclampsia, brain imaging displays signs compatible with raised intracranial pressure. We aimed to estimate the incidence of raised intracranial pressure in preeclampsia using ocular ultrasonography.
METHODS: Optic nerve sheath diameter (ONSD) measurements were compared in 26 preeclamptic and 25 healthy pregnant women. For each optic nerve, two measurements were made (transverse plane and sagittal plane) using a 7.5 MHz ultrasound linear probe. Preeclamptic patients were followed-up until postpartum day 7.
RESULTS: Median ONSD values were significantly greater in preeclamptic patients compared with healthy pregnant women at delivery (5.4 mm (95% CI: 5.2, 5.7) vs. 4.5 mm (95% CI: 4.3, 4.8), P < 0.0001). At delivery, 5/26 (19%) of preeclamptic patients had ONSD values above 5.8 mm (value associated in the literature with 95% risk of raised intracranial pressure) whereas none of the healthy pregnant group had such high ONSD values. In the preeclamptic group, ONSD decreased after the third postpartum day. ONSD values at day 7 were not significantly different from those obtained in the normal pregnancy group (P = 0.10).
CONCLUSION: In about 20% of preeclamptic patients, ONSD reaches values compatible with intracranial pressure above 20 mmHg. Further work is needed to confirm this incidence and to better understand the diagnostic and therapeutic usefulness of this easy-to-do monitoring technique.
Clément Dubost; Agnès Le Gouez; Viridiana Jouffroy; Sandrine Roger-Christoph; Dan Benhamou; Frédéric J Mercier; Thomas Geeraerts
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  116     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-26     Completed Date:  2012-06-19     Revised Date:  2013-01-10    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1066-71     Citation Subset:  AIM; IM    
Département d'Anesthésie-Réanimation, Hôpital Antoine Béclère, Clamart, France.
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MeSH Terms
Anesthesia, Obstetrical
Blood Pressure / physiology
Intracranial Hypertension / diagnosis*,  etiology,  ultrasonography*
Intracranial Pressure / physiology*
Myelin Sheath / ultrasonography*
Optic Nerve / ultrasonography*
Pilot Projects
Postpartum Period
Pre-Eclampsia / epidemiology,  physiopathology*
Comment In:
Anesthesiology. 2012 Dec;117(6):1396-7; author reply 1397   [PMID:  23168437 ]
Anesthesiology. 2012 May;116(5):983-4   [PMID:  22337164 ]

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