Detecting Pulmonary Edema in Obstetric Patients Through Point-of-Care Lung Ultrasonography

Obstet Gynecol. 2017 Mar;129(3):525-529. doi: 10.1097/AOG.0000000000001909.

Abstract

Background: Point-of-care lung ultrasonography is used in critical care settings for evaluating respiratory symptoms. Lung ultrasonography is sensitive and specific for the diagnosis of pulmonary edema in nonpregnant patients but is not well-studied in pregnancy.

Technique: Lung ultrasonography was performed using a portable ultrasound machine with a 2- to 5-MHz curvilinear probe that is available on many labor and delivery units.

Experience: Lung ultrasonography guided management decisions in a case of shortness of breath after induction of labor for preeclampsia and a case of hemolysis, elevated liver enzymes, and low platelet count syndrome complicated by pulmonary edema. Findings expedited diagnosis and treatment in both cases.

Conclusion: Lung ultrasonography has potential to be used in obstetrics for detecting pulmonary edema in preeclampsia. It is a well-established tool in critical care settings and use in obstetric patients should be studied given the availability of ultrasonography on labor and delivery and the importance of timely care for critically ill pregnant patients. It is a safe modality to evaluate pregnant women with respiratory symptoms and the necessary skills can be easily acquired by obstetric practitioners familiar with obstetric ultrasonography. Training of obstetric practitioners in this application of ultrasonography is needed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Point-of-Care Systems*
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging*
  • Pregnancy Complications / therapy
  • Pulmonary Edema / diagnostic imaging*
  • Pulmonary Edema / therapy
  • Ultrasonography / instrumentation
  • Ultrasonography / methods*