Krawczyk Paweł, Jastrzębska Agnieszka, Sałapa Kinga, Szczeklik Wojciech, Andres Janusz
Department of Anesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Cracow, Poland.
Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Cracow, Poland.
J Clin Ultrasound. 2019 Jun;47(5):261-266. doi: 10.1002/jcu.22692. Epub 2019 Feb 6.
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.
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.
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.
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.
肺部超声（LUS）检查用于评估急性呼吸衰竭患者。健康产妇分娩期间的生理性LUS表现尚未得到充分描述。本研究的目的是评估一组健康女性在无并发症分娩期间的LUS表现。
我们采用8点LUS评估方案，根据国际共识文件并增加两个膈上投影，调查肺滑动、A线、B线、间质综合征、肺实变和胸腔积液情况。所有患者均接受两次筛查，一次在分娩第一阶段，另一次在分娩后2小时内。
2014年2月至2015年8月，本研究纳入24例患者。共保留480份LUS记录用于进一步分析。总体而言，24例患者中有16例（67%）在分娩期LUS评估时有至少一个阳性区域（三条或更多B线）。5例患者（21%）检测到间质综合征。分娩前后LUS检查的A线（P = 0.38）或B线（P = 0.68）患病率无差异。
无并发症分娩的女性可能出现异常LUS表现，这可能影响对呼吸恶化患者LUS结果的解读。进一步研究应在更大的患者队列中探讨这一话题。
