The Effect of Epidural Anesthesia on the Optic Nerve Sheath Diameter in Preeclampsia

Study Overview
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Brief Summary
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This study aims to assess the effect of epidural anesthesia on the optic nerve sheath diameter in parturients with preeclampsia.

Detailed Description
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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.

Official Title
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The Effect of Epidural Anesthesia on the Optic Nerve Sheath Diameter in Preeclampsia: A Prospective Observational Study

Conditions
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Preeclampsia

Intervention / Treatment
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* Procedure: Epidural anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled to undergo planned cesarean section under epidural anesthesia if they have a singleton pregnancy, complicated by severe preeclampsia. Severe preeclampsia was defined using the American College of Obstetricians and Gynecologist Task Force on Hypertension in Pregnancy recommendations Controls will be healthy pregnant women at term (>37 weeks), with a singleton pregnancy, no signs or symptoms of preeclampsia and no intrauterine fetal growth restriction, who are planned to undergo elective cesarean delivery under epidural anesthesia Exclusion Criteria: Contraindication to epidural anesthesia Morbid cardiovascular disease Cerebrovascular disease Known fetal anomaly Any signs of onset of labor Body weight < 40 kg or body weight > 100 kg Height < 140cm or height > 190cm eye disease infection or trauma near the eyes abnormality of intracranial pressure due to Intracranial pathology

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Parturients with preeclampsia<br>Parturients who were diagnosed with preeclampsia | Procedure: Epidural anesthesia<br>* Epidural anesthesia using standardized technique<br>|
| Healthy parturients<br>Healthy full-term parturients | Procedure: Epidural anesthesia<br>* Epidural anesthesia using standardized technique<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 | 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 |