RESUMO
Background There are no data on usefulness of optic nerve sheath diameter (ONSD) as a marker of patient's fluid status in preeclampsia. The objective was to examine potential correlation between ONSD and lung ultrasound estimates of extravascular lung water in severe preeclampsia. Patients and methods Thirty patients with severe preeclampsia were included. Optic and lung ultrasound were performed within 24 hours from delivery. ONSD was measured 3 mm behind the globe. Lung ultrasound Echo Comet Score (ECS) was obtained summing B-lines ("comet tails") in parasternal intercostal spaces bilaterally. Pearson's correlation analysis was used to assess the relationship between ONSD and ECS (p < 0.05 significant). Results Median ONSD was 5.7 mm (range 3.8-7.5 mm). Median ECS value was 19 (range 0-24). Statistically significant correlation was found between ONSD and ECS (r2 = 0.464; p < 0.001). Conclusions Significant correlation between ONSD and ECS suggests optic ultrasound could be used for assessing fluid status and guiding peripartum fluid therapy in patients with severe preeclampsia.
Assuntos
Hipertensão Intracraniana/fisiopatologia , Pressão Intracraniana/fisiologia , Nervo Óptico/diagnóstico por imagem , Pré-Eclâmpsia/fisiopatologia , Ultrassonografia/métodos , Desequilíbrio Hidroeletrolítico/fisiopatologia , Adulto , Água Extravascular Pulmonar , Feminino , Humanos , Gravidez , Estudos Prospectivos , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/fisiopatologia , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To compare perinatal outcomes in different advanced maternal age groups. PATIENTS AND METHODS: We used a population-based data set to compare perinatal outcomes in three maternal age groups: 30-34.9, 35-39.9, and in women over 40 years. RESULTS: Over a 10-year period there were 23,422 (25.2%) births in the 35-39.9 years group, 3987 (4.3%) in the over 40 years group, and 65,492 births (70.5%) in our reference group (30-34.9 years). A direct significant relationship was found between maternal age and BMI and between pregnancy complications such as diabetes and hypertensive disorders, whereas an inverse relationship was found between older age and nuliparity and spontaneous conceptions. Also, older mothers had a higher incidence of both types of cesareans, and more early as well as late preterm births. Perinatal mortality was similar in all groups. CONCLUSIONS: Advanced maternal age is associated with higher, gradually increasing, incidence, of adverse perinatal outcomes.
