A comparative study of optic nerve sheath diameter and Lung Ultrasound score in healthy and preeclampsia parturients.

Background: Complications of preeclampsia include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.

Methods: In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.

Results: Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients [5.06 ± 0.46 vs 4.24 ± 0.38 mm (p < 0.0001) and [5 (1-12) vs 0 (0-1.5); p value <0.0001], respectively. Mean ONSD in severe pre-eclampsia (5.36 ± 0.32 mm) was significantly higher as compared to mild pre-eclampsia (4.71 ± 0.35 mm; p < 0.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of >4.65 mm and LUSS of >2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.

Conclusion: Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.

Ctri registration: CTRI/2019/12/022243 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37940&EncHid=&userName=). IEC: LHMC/IEC/Thesis/2019/116 dated 29/10/2019.