Internal Jugular Vein Collapsibility Index for Volume Status Assessment in Preeclampsia in Correlation With Normotensive Parturients

Inclusion criteria

• Singleton parturients from 18 to 40 years old.
• Either normotensive or preeclamptic parturients scheduled for elective cesarean section under neuro-axial block matched for gestational age 28-40 weeks will be included:
• Normotensive group: uncomplicated normotensive pregnancy with systolic blood pressure below 140 mmHg and diastolic blood pressure below 90mmHg without proteinuria.
• Preeclamptic Group: new onset preeclamptic pregnant female with gestational hypertension after 20 weeks of pregnancy diagnosed based on ISSHP Guidelines: systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, accompanied by one or more of the following:
• Proteinuria (≥300 mg in a 24-hour urine sample)
• Alb/Cr ratio ≥30 mg/mmol,
• Organ dysfunction (renal insufficiency (creatinine level\>1.1mg%), liver involvement (liver enzyme levels ≥3 times normal), neurological complications (Headache and blurring of vision) and hematological involvement (thrombocytopenia\<100.000)).

Exclusion criteria

• Parturients with pre-existing cardiac \& vascular disease affecting blood volume and vascular compliance: (Valvular or congenital heart disease, arrhythmia, previous history of venous thromboembolism, chronic kidney disease, gestational diabetes).
• multiple gestations
• known thyroid disorders or chronic hypertension
• patients with BMI \>40 and patients requiring emergency delivery.