Meshi Amit, Armarnik Sharon, Mimouni Michael, Segev Fani, Segal Ori, Kaneti Hagai, Assia Ehud I, Geffen Noa
Departments of *Ophthalmology ‡Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv University, Kfar Saba †Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
J Glaucoma. 2017 Jan;26(1):59-64. doi: 10.1097/IJG.0000000000000559.
To investigate the effect of modern vaginal labor using epidural anesthesia on the intraocular pressure (IOP) and on the mean ocular perfusion pressure (MOPP) in healthy women.
In this prospective observational study, eligible candidates were healthy pregnant women for vaginal delivery with epidural anesthesia, with a singleton pregnancy, who were admitted to the delivery room in the first phase of the first stage of labor. Demographic data as well as medical and obstetric history were obtained at baseline, followed by performance of a biomicroscopic examination. IOP, maternal heart rate, systolic blood pressure, and diastolic blood pressure were measured in the first, second and third stages of labor, 24±2 and 48±2 hours postpartum. IOP was not measured during the contraction phase of stage 2. MOPP was expressed as the difference between the arterial blood pressure and the IOP. Measurements were performed throughout the different stages of labor and were compared with baseline values.
Thirty healthy white women were enrolled. Four women dropped out due to unexpected cesarean sections. The average age was 31.8±4.7 years. Nineteen participants received oxytocin during delivery. Twenty-three women were placed in a supine position, whereas 3 in a left decubitus position. No statistically significant changes were recorded in IOP (P=0.50) or MOPP (P=0.17) throughout the different stages of vaginal labor in this study.
Vaginal delivery under epidural anesthesia is unlikely to cause significant damage to the optic nerve in healthy women.
研究硬膜外麻醉下现代阴道分娩对健康女性眼压（IOP）和平均眼灌注压（MOPP）的影响。
在这项前瞻性观察研究中，符合条件的受试者为计划进行硬膜外麻醉下阴道分娩的健康孕妇，单胎妊娠，且在第一产程第一阶段进入产房。在基线时获取人口统计学数据以及医疗和产科病史，随后进行生物显微镜检查。在第一产程、第二产程和第三产程、产后24±2小时和48±2小时测量眼压、产妇心率、收缩压和舒张压。第二产程宫缩期未测量眼压。平均眼灌注压以动脉血压与眼压之差表示。在分娩的不同阶段进行测量，并与基线值进行比较。
招募了30名健康白人女性。4名女性因意外剖宫产退出。平均年龄为31.8±4.7岁。19名参与者在分娩期间接受了催产素。23名女性采取仰卧位，3名采取左侧卧位。在本研究中，阴道分娩不同阶段的眼压（P=0.50）或平均眼灌注压（P=0.17）均未记录到统计学上的显著变化。
硬膜外麻醉下的阴道分娩不太可能对健康女性的视神经造成显著损害。
