Lung Ultrasound Predicts Interstitial Syndrome and Hemodynamic Profile in Parturients with Severe Preeclampsia

Zieleskiewicz, Laurent; Contargyris, Claire; Brun, Clément; Touret, Maxime; Vellin, Armand; Antonini, François; Muller, Laurent; Bretelle, Florence; Martin, Claude; Léone, Marc

doi:10.1097/aln.0000000000000102

Cited by 98 publications

(94 citation statements)

References 62 publications

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“…Pediatrics 2014;134:e1089-e1094 Accepted for publication Jul 24, 2014 Chest ultrasound has recently been applied with success in different settings of adult medicine, ranging from cardiopulmonary emergencies and trauma surgery to the care of preeclamptic women or patients with renal failure. [1][2][3][4] A systematic ultrasound semeiology has been validated across a wide span of ages using both chest anatomic structures (ie, the ribs or the pleural line) and artifactual images, such as the B-lines, that are discrete, laserlike vertical hyperechoic reverberations arising from the pleural line. Multiple diffuse bilateral B-lines are suggestive of interstitial syndrome (eg, pulmonary edema, interstitial pneumonia, diffuse parenchymal lung disease) 5 (Fig 1A).…”

Section: Discussionmentioning

confidence: 99%

Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

et al. 2014

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“…27,38,40,53,57 Interestingly E/e′ was shown to be significantly higher in an early-onset preeclampsia subgroup compared with a late-onset subgroup. 40 One study used a composite of diastolic indices to diagnose diastolic dysfunction and demonstrated diastolic dysfunction in 40% of pregnancies complicated by preeclampsia at term, compared with 14% of controls.…”

Section: Diastolic Functionmentioning

confidence: 99%

“…The use of different calculations (based either on Doppler or volume calculation) is likely to contribute to the disparity for this parameter. There was similar variability with regard to LV ejection fraction, with the majority of studies showing no significant difference compared with normotensive pregnant women 30,38,52,56,57 and only 1 showing a decrease. 33 Myocardial performance index was reduced in a study of women with preeclampsia and fetal growth restriction in the third trimester.…”

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confidence: 92%

“…[22][23][24] The majority of studies (n=20) were of women with preeclampsia. 23,[26][27][28][29][30]33,38,[40][41][42]44,[50][51][52][53][55][56][57] There were 9 studies assessing GH only 24,32,35,37,39,43,48,49,54 and 7 studies evaluating both GH and preeclampsia. 22,25,31,34,36,43,45 All investigators recruited women during antenatal visits to hospital.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…23,25 Other obstetric outcomes, for example, birthweight and gestation at delivery, were recorded in 15 of the studies. 22,23,[26][27][28][29]31,32,40,42,45,50,51,56,57 Only 3 studies analyzed the relationship between these pregnancy outcomes and echocardiographic measurements 32,42,45 (Table III in the Data Supplement).…”

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Echocardiographic Structure and Function in Hypertensive Disorders of Pregnancy

Castleman

Ganapathy

Taki

et al. 2016

Circ: Cardiovascular Imaging

106

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C ardiac disease is the leading non-obstetric cause of death in pregnancy and the puerperium. 1 In uncomplicated pregnancy, there is no significant change in systolic blood pressure.2,3 Diastolic blood pressure and mean arterial pressure decrease during the first trimester and then plateau in the second trimester before rising in the final weeks of pregnancy. 2,3 Hypertension is seen in 6% to 8% of pregnancies 4 and the incidence is increasing as the obstetric population becomes older and more obese. 5 Hypertension causes one third of severe maternal morbidity 4 and is the second most common direct cause of maternal mortality worldwide, accounting for ≈14% of maternal deaths. 6 Adverse fetal outcomes include preterm birth, growth restriction, and stillbirth. See Clinical PerspectiveThe hypertensive disorders specific to pregnancy are gestational hypertension (GH) and preeclampsia. Guidelines and terminology vary across the world. 4,[7][8][9][10] The diagnosis and classification of these conditions depend on the gestation at which elevated blood pressure is identified (GH and preeclampsia are acquired conditions in the second half of pregnancy), the presence or absence of multisystem involvement or significant proteinuria (traditionally the hallmark of preeclampsia 4 ), and whether the blood pressure normalizes in the postnatal period. The onset of hypertension in GH and preeclampsia must be after 20 weeks of gestation to distinguish them from chronic hypertension. Preeclampsia can develop in patients with GH and also be superimposed on chronic hypertension.Understanding the structure and function of the heart in pregnancy is vital if we are to recognize abnormalities at an Background-Echocardiography is commonly used to direct the management of hypertensive disorders in medical patients, but its application in pregnancy is unclear. Our objective was to define the use of echocardiography in pregnancies complicated by gestational hypertension (GH) and preeclampsia. Methods and Results-We performed a systematic review of articles using an electronic search of databases from inception to March 2015, prospectively registered with PROSPERO (CRD42015015700). Eligible studies included pregnant women with GH or preeclampsia, evaluating left ventricular structure and function using echocardiography. The search strategy identified 36 studies, including 745 women with GH and 815 women with preeclampsia. The populations were heterogeneous with respect to clinical characteristics, parity, and risk of bias. Increased vascular resistance and left ventricular mass were the most consistent findings in GH and preeclampsia. Differentiating features from normal pregnancy were left ventricular wall thickness of ≥1.0 cm, exaggerated reduction in E/A, and lateral e′ of <14 cm/s. There was disagreement between studies with regard to cardiac output because of the timing of echocardiography, although reduced stroke volume was an indicator of adverse prognosis. Diastolic dysfunction and left ventricular remodeling are most marked i...

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

Krawczyk

Jastrzębska

Sałapa

et al. 2019

J of Clinical Ultrasound

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Purpose Lung ultrasound (LUS) examination is used to evaluate patients with acute respiratory failure. The physiological LUS pattern during labor in healthy parturients has not been well described. The aim of this study was to evaluate the LUS pattern in a cohort of healthy women during uncomplicated labor. Methods We used the 8‐point LUS assessment protocol and investigated lung sliding, A‐lines, B‐lines, interstitial syndrome, lung consolidation, and pleural effusion according to the International Consensus Document with two additional supradiaphragmatic projections. All patients were screened twice; once during the first stage of labor and again within 2 hours after delivery. Results We included 24 patients in this study from February 2014 to August 2015. A total of 480 LUS records were retained for further analysis. Overall, 16 of 24 patients (67%) had at least one positive region (three or more B‐lines) during the peridelivery LUS evaluation. Interstitial syndrome was detected in five patients (21%). There were no differences in A‐line (P = 0.38) or B‐line (P = 0.68) prevalence between LUS examinations before and after delivery. Conclusions Women in uncomplicated labor can present abnormal LUS findings, which may affect the interpretation of LUS results in patients with respiratory deterioration. Further studies should address this topic in larger cohort of patients.

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Lung Ultrasound Predicts Interstitial Syndrome and Hemodynamic Profile in Parturients with Severe Preeclampsia

Cited by 98 publications

References 62 publications

Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

Echocardiographic Structure and Function in Hypertensive Disorders of Pregnancy

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

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