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This study aims to assess the effect of epidural anesthesia on the optic nerve sheath diameter in parturients with preeclampsia.
This prospective observational study will be performed in parturients, either with or without preeclampsia, who scheduled to undergo elective cesarean delivery under epidural anesthesia. Epidural anesthesia will be done according to the standard technique. Optic nerve sheath diameter (ONSD) will be measured before and after the epidural injection of anesthetic solutions using ultrasonography. The investigators will assess whether epidural anesthesia has effect on optic nerve sheath diameter of pregnant women, and the investigators will also compare ONSD between healthy parturients and parturients with preeclampsia. The investigators will evaluate the relationship between ONSD and disease severity of preeclampsia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Parturients with preeclampsia | Parturients who were diagnosed with preeclampsia |
| |
| Healthy parturients | Healthy full-term parturients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Epidural anesthesia | Procedure | Epidural anesthesia using standardized technique |
|
| Measure | Description | Time Frame |
|---|---|---|
| Optic nerve sheath diameter (ONSD) after epidural anesthesia | measured by transocular ultrasonography | 3 minutes after the completion of epidural injection of the anesthetic solutions |
| Measure | Description | Time Frame |
|---|---|---|
| Optic nerve sheath diameter (ONSD) | measured by transocular ultrasonography | before epidural anesthesia, 10, 20 minutes after the completion of epidural injection of the anesthetic solutions, 10 minutes after delivery of fetus, at the end of surgery. |
| Blood pressure |
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Inclusion Criteria:
Severe preeclampsia was defined using the American College of Obstetricians and Gynecologist Task Force on Hypertension in Pregnancy recommendations
Exclusion Criteria:
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We plans to include 11 preeclamptic patients and 11 healthy pregnant women.
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| Name | Affiliation | Role |
|---|---|---|
| Jin-Tae Kim, MD, PhD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30057149 | Background | Brzan Simenc G, Ambrozic J, Prokselj K, Tul N, Cvijic M, Mirkovic T, Lucovnik M. Ocular ultrasonography for diagnosing increased intracranial pressure in patients with severe preeclampsia. Int J Obstet Anesth. 2018 Nov;36:49-55. doi: 10.1016/j.ijoa.2018.06.005. Epub 2018 Jul 4. | |
| 31094790 | Background | Ortner CM, Krishnamoorthy V, Neethling E, Flint M, Swanevelder JL, Lombard C, Fawcus S, Dyer RA. Point-of-Care Ultrasound Abnormalities in Late-Onset Severe Preeclampsia: Prevalence and Association With Serum Albumin and Brain Natriuretic Peptide. Anesth Analg. 2019 Jun;128(6):1208-1216. doi: 10.1213/ANE.0000000000003759. |
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| ID | Term |
|---|---|
| D011225 | Pre-Eclampsia |
| ID | Term |
|---|---|
| D046110 | Hypertension, Pregnancy-Induced |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D000767 | Anesthesia, Epidural |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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blood pressure in mmHg |
| on delivery day |
| Proteinuria | The presence of Proteinuria during the admission period | during the admission period |
| Epigastric pain | The occurrence of epigastric pain during the admission period | during the admission period |
| Headache | The occurrence of Headache during the admission period | during the admission period |
| Visual disturbances | The occurrence of Visual disturbances during the admission period | during the admission period |
| Oliguria | The occurrence of Oliguria during the admission period | during the admission period |
| eclampsia | The occurrence of seizure during the admission period | during the admission period |
| intracranial hemorrhage | The occurrence of intracranial hemorrhage during the admission period | during the admission period |
| Serum creatinine | Serum creatinine concentration | during the admission period |
| Serum albumin | Serum albumin concentration | during the admission period |
| Platelet count | Platelet count measured during the admission period | during the admission period |
| AST | AST measured during the admission period | during the admission period |
| Apgar Score of fetus | Apgar Score of delivered fetus | at 1 min, 5 min |
| Umbilical arterial pH | pH in mmol/L, Umbilical arterial blood gas analysis | immediately after delivery |
| ALT | ALT measured during the admission period | during the admission period |
| Umbilical arterial base excess | base excess in mmol/L, Umbilical arterial blood gas analysis | immediately after delivery |
| Umbilical arterial PO2 | PO2 in mmHg, Umbilical arterial blood gas analysis | immediately after delivery |
| Umbilical arterial PCO2 | PCO2 in mmHg, Umbilical arterial blood gas analysis | immediately after delivery |
| 38950931 | Derived | Park SK, Kim H, Kim Y, Jang YE, Kim JT. Effect of epidural anesthesia on the optic nerve sheath diameter in patients with pre-eclampsia: a prospective observational study. Reg Anesth Pain Med. 2025 Oct 6;50(10):828-834. doi: 10.1136/rapm-2024-105444. |