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Amit Meshi, Sharon Armarnik, Haggai Kaneti, Fani Segev, Ehud Assia, Noa Geffen; The Effect of Child Delivery Process on the Intraocular Pressure in Healthy Women. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5620.
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To investigate the effect of vaginal child delivery on the intraocular pressure (IOP) in healthy women.
Open, prospective, non-randomized, single center clinical trial, enrolling healthy pregnant women candidates for vaginal delivery at their acceptance to the delivery room. Medical, ophthalmic and obstetric histories were obtained at enrollment and biomicroscopic examination using a portable slit lamp was performed. Heart rate (HR), blood pressure (BP) and IOP (in 1 randomly selected eye, using a Tonopen XL) were measured at enrollment, during the 1st (latent and active phases), 2nd and 3rd stages of the delivery and at 24, 48 hours postpartum. The average of 3 IOP measurements (variance<5%) was calculated. Labor position and drugs were documented.
Thirty healthy Caucasian women were recruited. Average age was 31.5 years (range 19-41). Mean gestational age was 39.2 weeks. The mean number of pregnancies and deliveries was 3 and 2.2, respectively. Four women had dropped-out from the study due to an unplanned conversion to cesarean section. Fourteen women required induction of labor with oxytocin and one underwent vacuum-assisted delivery. All women received epidural anesthesia. Twenty two women were in supine position, 3 in left decubitus position and 1 in right decubitus position. The mean IOP (±standard deviation) measured on admission, during the latent and active phases of the 1st stage of delivery, during the 2nd and 3rd stages of delivery and 24, 48 hours post-delivery were 11.8±3.6 mm Hg, 11.9±3.3 mm Hg, 11.8±2.9 mm Hg, 12.1±3.1 mm Hg, 12.2±4.0 mm Hg, 11.9±2.4 mm Hg and 13.2±2.3 mm Hg, respectively (P > 0.05). Mean HR and BP remained stable during all stages of delivery.
To the best of our knowledge this is the first time that the impact of the modern labor on the IOP was investigated. The IOP changes documented during vaginal delivery under an epidural anesthesia were within the physiologic diurnal variation range. IOP changes during labor probably have no clinical significance in healthy women and should not serve as an indication for changes in the planned management of labor.
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