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Hypertensive disorders of pregnancy (HPT) are an important cause of maternal-feto-neonatal morbidity and mortality, being one of the three leading causes of maternal death in our country and in developing countries. The only cure for THE is termination of pregnancy, which ends up being a decision in which gestational age and maternal risks must be balanced. Angiogenic factors have come to occupy an indispensable place in the arsenal of tools that can be used to separate the patient with a high likelihood of complications from those in whom prolongation of pregnancy could represent an important neonatal benefit. Refining the diagnostic capability of this test would further improve maternal-fetal outcomes and the use of optic nerve sheath diameter (ONSD) measurement could make the difference.
The purpose of the present study is to correlate the measurement of ONSD with serum angiogenic factor (AF) values in patients with pre-eclampsia and to determine its predictive ability for adverse perinatal outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-eclampsia | Experimental | Subjects admitted with severe pre-eclampsia, based on the criteria by the American College of Obstetricians and Gynecologists (ACOG) |
|
| Control | Active Comparator | Subjects admitted for normal labor, without any criteria of pre-eclampsia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ONSD+AF | Procedure | Measurement of the optic nerve sheath diameter and of sFLT-1/PGIF index |
|
| Measure | Description | Time Frame |
|---|---|---|
| Optic nerve sheath diameter cut off value | Value in mms of the optic nerve sheath diameter for the diagnosis of severe preeclampsia | Up to discharge. On average, 7 days. |
| sFLT-1/PiGF index | Value of the index between the sFlt-1/PIGF (angiogenic factor) for the diagnosis of severe preeclampsia | Up until discharge. On average, 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Maternal/fetal morbidity | Presence of any/several indicators of maternal or fetal morbidity (abruptio placenta, HELLP syndrome, eclampsia, fetal growth restriction, acute lung edema). | Up until discharge. On average, 7 days |
| Neonatal morbidity |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Osvaldo Reyes, MD | Contact | +507 65655041 | oreyespanama@yahoo.es | |
| Adriana Martinz, MD | Contact | amartinzmd@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Saint Thomas Hospital | Recruiting | Panama City | Provincia de Panamá | Panama |
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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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Presence of any/several indicators of neonatal morbidity (Apgar scores, admission to NICU, encephalophatic hypoxia)
| Up until discharge. On average, 3 days |