Pachtman Sarah, Koenig Seth, Meirowitz Natalie
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.
Obstet Gynecol. 2017 Mar;129(3):525-529. doi: 10.1097/AOG.0000000000001909.
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.
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.
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.
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.
床旁肺部超声检查用于重症监护环境中评估呼吸道症状。肺部超声检查对非妊娠患者肺水肿的诊断具有敏感性和特异性，但在妊娠患者中的研究较少。
使用便携式超声仪及2至5兆赫兹的曲线探头进行肺部超声检查，许多产房都配备这种设备。
在1例先兆子痫引产术后呼吸急促病例以及1例并发肺水肿的溶血、肝酶升高和血小板减少综合征病例中，肺部超声检查指导了管理决策。检查结果加快了两例病例的诊断和治疗。
肺部超声检查在产科有潜力用于检测先兆子痫患者的肺水肿。它在重症监护环境中是一种成熟的工具，鉴于产房可进行超声检查以及及时治疗重症妊娠患者的重要性，应研究其在产科患者中的应用。评估有呼吸道症状的孕妇时，它是一种安全的检查方式，熟悉产科超声检查的产科医生可以轻松掌握必要技能。需要对产科医生进行这种超声检查应用方面的培训。
