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

Pachtman, Sarah MD; Koenig, Seth MD; Meirowitz, Natalie MD

doi: 10.1097/AOG.0000000000001909
Contents: Procedures and Instruments

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.

Lung ultrasonography is a useful tool to evaluate pregnant women for pulmonary edema.

Divisions of Maternal-Fetal Medicine and Pulmonary and Critical Care Medicine, Hofstra-Northwell School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York.

Corresponding author: Sarah Pachtman, MD, Long Island Jewish Medical Center, Division of Maternal-Fetal Medicine, 270-05 76th Avenue, New Hyde Park, NY 11040; email: spachtman@northwell.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented at the International Society of Ultrasound in Obstetrics and Gynecology 2016 World Congress Conference, September 25–28, 2016, Rome, Italy.

The authors thank Lee Weissman and Robert Hinton for their assistance with photography.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.