Lung Ultrasound Pattern Is Normal during the Last Gestational Weeks: An Observational Pilot Study

Abstract

Background/Aims: The normal lung ultrasound (US) pattern during a regular pregnancy has not been evaluated extensively in the current literature. Pregnancy-related changes in the respiratory tract affect maternal predisposition to several respiratory complications; consequently, it is important to differentiate between a physiologic pattern during pregnancy and a pathologic lung pattern, due to respiratory failure. The goal of our study was to assess the normal US lung pattern in women without known comorbidities in the last weeks of pregnancy. Methods: We conducted a prospective cross-sectional observational pilot study. Chest wall was examined in 8 areas, 1 scan for each area with women in supine position. Results: One hundred fifty parturients were enrolled during the 36th-38th gestational weeks. None of the participants showed pleural effusion, pneumothorax or lung consolidation. None presented an interstitial syndrome US pattern. One hundred thirteen participants out of 150 (75%) showed A-lines in all the regions. The remaining 25% showed 1 or 2 B-lines in at least 3 regions. Only 2 participants showed 2 positive regions also. Conclusions: We found that, in the majority of the women examined, the lung US pattern matches the physiological pattern in non-pregnant patients. Lung US assessment is a feasible and a helpful diagnostic tool during pregnancy.

Abnormal lung ultrasound pattern during labor: A prospective cohort pilot study

“…We detected no abnormalities in the physical examination, vital parameters or laboratory test results of patients with common B‐lines and an interstitial syndrome pattern on LUS. In our study an interstitial syndrome pattern was not associated with older‐aged, obese, or multiparous women, as suggested in the literature . Our findings may influence the interpretation of LUS images in laboring patients showing deterioration resulting in B‐lines LUS pattern.…”

“…Arbeid et al used the same 8‐point LUS assessment protocol and reported the presence of only A‐lines in 75% of nonlaboring pregnant patients . In our study, only 3 of 24 women in labor had only A‐lines on LUS either before or after delivery.…”

“…Increased extravascular lung water is associated with B‐line artifacts . Arbeid et al did not note increased lung water during pregnancy on LUS, with B‐lines being uncommon in their patients . B‐lines were more common in our study, both in labor and within 2 hours after delivery.…”

“…A few reports describe a normal LUS pattern in pregnant women, but none of them included women in labor . Arbeid et al reported that the LUS pattern in nonlaboring women at 36 to 38 weeks gestation was similar to that of the nonpregnant population.…”

“…Despite literature being published concerning the LUS pattern during the last few gestational weeks, the LUS pattern in physiological terms, and how it changes during labor in a healthy population of parturients, has not been fully described. Several factors during normal labor contribute to changes in the LUS pattern.…”