Focused cardiac ultrasound is feasible in parturients; a prospective observational study

Acta Anaesthesiol Scand. 2017 Oct;61(9):1105-1113. doi: 10.1111/aas.12956. Epub 2017 Aug 22.

Abstract

Background: In pregnancy, the major causes of morbidity and mortality include diseases that affect circulation profoundly and restoration of normal circulation is a key objective. Focused cardiac ultrasound provides information on the individual determinants of circulation and has a significant impact on patient management. This study aimed to determine the feasibility of focused cardiac ultrasound in term parturients.

Methods: Forty parturients underwent focused cardiac ultrasound. Parasternal long-axis, parasternal short-axis, 4-chamber and subcostal views were performed in the left-lateral position and the supine position by a novice operator. All images were graded on the following scale: 1 = no image; 2 = poor and insufficient image; 3 = sufficient image quality; 4 = good image quality; 5 = perfect image quality. A cut-off grade of three signified images sufficient for clinical decision-making.

Results: Images sufficient for clinical decision-making were obtained in all patients when including all imaging views. 37/40 (93 %) patients presented images of grade ≥ 4, whereas 10/40 (25%) patients had images of grade 5. Image grades were higher in the left lateral position (all P < 0.001). Parturients with a body mass index ≤ 30 kg/m2 did not present different image grades than parturients with a higher body mass index (P = 0.753). Subcostal views could not be obtained.

Conclusion: Focused cardiac ultrasound is feasible in the obstetric population and images of sufficient quality for clinical decision-making were obtained in all parturients by an operator with limited experience.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Clinical Decision-Making
  • Echocardiography / methods*
  • Endpoint Determination
  • Feasibility Studies
  • Female
  • Humans
  • Obesity / diagnostic imaging
  • Overweight / diagnostic imaging
  • Pregnancy Complications / diagnostic imaging
  • Pregnancy*
  • Prospective Studies
  • Reproducibility of Results
  • Supine Position
  • Young Adult