urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.4.103NZEFFTurmj-1938Research ArticleОригинальные статьи | Original articlesOriginal articlesВзаимосвязь тяжести гипертензивных расстройств во время беременности и ряда параметров ультразвукового исследования зрительного нерваThe Relationship Between the Severity of Hypertensive Disorders During Pregnancy and a Number of Ultrasonic Optic Nerve Parametershttps://orcid.org/0000-0002-6223-8888ТаскинаЕ. С.TaskinaE. S.

Таскина Елизавета Сергеевна — кандидат медицинских наук, доцент кафедры офтальмологии.

Чита

Elizaveta S. Taskina — Candidate of Sciences (Medicine), Associate Professor of the Department of Ophthalmology, Chita State Medical Academy.

Chita

taskins@yandex.ruhttps://orcid.org/0000-0002-5961-5400МудровВ. А.MudrovV. A.

Мудров Виктор Андреевич — доктор медицинских наук, доцент, профессор кафедры акушерства и гинекологии педиатрического факультета и факультета дополнительного профессионального образования.

Чита

Victor A. Mudrov — Doctor of Sciences (Medicine), Associate Professor, Professor of the Department of Obstetrics and Gynecology of the Faculty of Pediatrics and the Faculty of Continuing Professional Education, Chita State Medical Academy.

Chita

mudrov_viktor@mail.ruhttps://orcid.org/0000-0003-4390-183XКибалинаИ. В.KibalinaI. V.

Кибалина Ирина Владимировна — доктор медицинских наук, доцент, директор научно-исследовательского института молекулярной медицины, заведующий кафедрой нормальной физиологии имени профессора Б.И. Кузника.

Чита

Irina V. Kibalina — Doctor of Sciences (Medicine), Associate Professor, Director of the Research Institute of Molecular Medicine, Head of the Department of Normal Physiology named after Professor B.I. Kuznik, Chita State Medical Academy.

Chita

physiology_chgma@mail.ruЧитинская государственная медицинская академияРоссияChita State Medical AcademyRussian Federation202527082025244103–115Copyright © Таскина Е.С., Мудров В.А., Кибалина И.В., 20252025Таскина Е.С., Мудров В.А., Кибалина И.В.Taskina E.S., Mudrov V.A., Kibalina I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1938Обоснование

Обоснование. Гипертензивные расстройства во время беременности остаются одной из ведущих причин материнской и перинатальной заболеваемости и смертности. Эти состояния требуют своевременной диагностики для предотвращения тяжелых церебральных осложнений.

Цель исследования — определить характер зависимости между тяжестью гипертензивных расстройств у беременных и сонографическими изменениями параметров зрительного нерва.

Материалы и методы

Материалы и методы. Обследовано 80 беременных, разделенных на 4 группы исследования: пациентки с нормальной беременностью (n = 20), гестационной артериальной гипертензией (n = 20), умеренной (n = 25) и тяжелой преэклампсией (n = 15). Проведено комплексное офтальмологическое обследование, включая ультразвуковое исследование зрительного нерва с определением диаметра его склерального канала (ДСКЗН), высоты диска (ДЗН), его диаметра с оболочкой (ДОЗН) и без нее (ДБОЗН).

Результаты

Результаты. Обнаружена прямая связь заметной силы значения высоты ДЗН с ДБОЗН, а также ДОЗН. Выявлена обратная корреляционная связь заметной силы между значением высоты ДЗН и ДСКЗН. При значении высоты ДЗН ≥0,5 мм и ДБОЗН >2,6 мм риск развития тяжелой преэклампсии возрастает более чем в 2,5 раза. При значении ДОЗН ≥5,7 мм риск развития тяжелой преэклампсии возрастает более чем в 7 раз. Обсуждение. При повышении внутричерепного давления у беременных с преэклампсией происходит увеличение высоты ДЗН, ДОЗН и ДБОЗН. Выраженность отека ДЗН зависит не только от степени внутричерепной гипертензии, но и от индивидуальных анатомических особенностей строения склерального канала зрительного нерва.

Заключение

Заключение. Установлена тесная связь между ультразвуковыми параметрами зрительного нерва и риском развития преэклампсии. Высота ДЗН имеет прямую связь с ДБОЗН и ДОЗН. Обнаружена обратная связь между высотой ДЗН с ДСКЗН, что ограничивает изолированное использование ультразвуковых значений высоты ДЗН в качестве инструментального маркера тяжести преэклампсии.

Background

Background. Hypertensive disorders during pregnancy remain one of the leading causes of maternal and perinatal morbidity and mortality. These conditions require timely diagnosis to prevent severe cerebral complications.

The aim of the study was to determine the nature of the relationship between the severity of hypertensive disorders in pregnant women and sonographic changes in optic nerve parameters.

Materials and methods

Materials and methods. 80 pregnant women were examined, divided into 4 study groups: patients with normal pregnancy (n = 20), with gestational hypertension (n = 20), moderate (n = 25) and severe preeclampsia (n = 15). A comprehensive ophthalmological examination was performed, including ultrasound optic nerve examination with the determination of scleral canal diameter (SCD), optic disc height (ODH), optic nerve diameter (OND) and optic nerve sheath diameter (ONSD).

Results

Results. А direct relationship of noticeable strength was found between ODH with OND, as well as with ONSD. An inverse correlation of noticeable strength between ODH and SCD has been revealed. With ODH >0.5 mm and OND >2.6 mm, the risk of developing severe preeclampsia increases by more than 2.5 times. With ONSD >5.7 mm, the risk of developing severe preeclampsia increases by more than 7 times.

Conclusion

Conclusion. A close relationship has been established between ultrasound parameters of the optic nerve and the risk of preeclampsia. ODH has a direct relationship with ONSD and OND. The discovered inverse relationship between ODH and SCD limits the isolated use of ultrasound values of ODH as an instrumental marker of preeclampsia severity.

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The authors declare that there are no conflicts of interest present.