Background
Lung ultrasound could identify increased levels of extra-vascular lung water (EVLW) in severe preeclampsia (PE) also; increased optic nerve sheath diameter (ONSD) can indirectly reflect intracranial edema that could be a part of PE generalized edema. Our study aimed to evaluate the correlation between ONSD and EVLW in severe PE and to calculate ONSD cutoffs for prediction of pulmonary congestion severity degrees.
Methods
This prospective cohort study was conducted on 54 consecutively admitted singleton pregnant females complicated with severe preeclampsia from October 2019 to April 2020. Lung ultrasound for quantification of The Echo Comet Score (ECS) and optic nerve ultrasound assessments were performed for all enrolled parturients within 24 h before delivery and at 24 h post-delivery.
Results
Statistically high significant correlation was found between ECS and ONSD measurements both before and after delivery (r2 = 0.960, p < 0.001 and r2 = 0.847, p < 0.001 for before and after delivery, respectively). Statistically, both ECS and ONSD were highly significant lower at 24 h after delivery compared to the before delivery. The albumin level was statistically highly significant low in patients with severe pulmonary congestion. ONSD measured within 24 hours before delivery with 5.6–6.4 mm in diameter could predict moderate pulmonary congestion with 94.12% sensitivity and 100% specificity and ONSD > 6.4 mm predict severe pulmonary congestion with 100% sensitivity and 94% specificity.
Conclusion
ONSD is significantly correlated with EVLW in severe preeclampsia and it can predict the degree of pulmonary congestion with cutoff >6.4 mm predicts severe pulmonary congestion.