Menon Lakshmi Priya, Balakrishnan Jayaraj Mymbilly, Wilson William, Thomas Mariam Koshi
Department of Anaesthesiology and Critical Care, Aster Medcity, Cochin, Kerala, India.
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Emerg Trauma Shock. 2020 Jan-Mar;13(1):50-53. doi: 10.4103/JETS.JETS_136_18. Epub 2020 Mar 19.
Uncorrected maternal hypotension occurring during obstetric emergencies may result in maternal and fetal morbidity. Fluid status of the pregnant mother is a major variable which affects the maternal hemodynamics during patient management, and there is no objective assessment tool for the same. A relatively new sonographic parameter, the inferior vena cava aorta (IVC/Ao) diameter index or caval aortic index, showed promise in this regard, and its application was studied in obstetric patients.
A prospective analytical study was conducted involving 50 pregnant and 50 nonpregnant women of reproductive age group. Using both subxiphoid and transhepatic views, their normal fasting caval aortic indices were determined from the ratio of mean IVC diameter to the mean aortic diameter. Descriptive and inferential statistical analyses were carried out accordingly.
Normal IVC/Ao diameter index for nonpregnant healthy women of reproductive age was 1.11 ± 0.29 in the subxiphoid view and 1.21 ± 0.33 in the transhepatic view. The difference between the two views was not statistically significant. IVC/Ao diameter index for a normal term pregnant woman was 1.03 ± 0.26, and term pregnancy does not significantly cause variation in the index.
Caval aortic index is a useful noninvasive tool to assess volume status and guide fluid management in pregnant women presenting to the emergency department, and the transhepatic view is comparable to the traditional subxiphoid view for the measurement of the same.
产科急症期间未纠正的母体低血压可能导致母体和胎儿发病。孕妇的液体状态是影响患者管理期间母体血流动力学的一个主要变量，并且对此没有客观的评估工具。一个相对较新的超声参数，即下腔静脉主动脉（IVC/Ao）直径指数或腔主动脉指数，在这方面显示出前景，并在产科患者中对其应用进行了研究。
进行了一项前瞻性分析研究，纳入了50名育龄期孕妇和50名非孕妇。使用剑突下和经肝视图，通过平均IVC直径与平均主动脉直径的比值确定她们正常空腹时的腔主动脉指数。相应地进行了描述性和推断性统计分析。
育龄期非孕健康女性在剑突下视图中正常的IVC/Ao直径指数为1.11±0.29，在经肝视图中为1.21±0.33。两种视图之间的差异无统计学意义。足月孕妇的IVC/Ao直径指数为1.03±0.26，足月妊娠并未显著导致该指数的变化。
腔主动脉指数是评估急诊科孕妇容量状态和指导液体管理的一种有用的非侵入性工具，并且经肝视图与传统的剑突下视图在测量该指数方面具有可比性。
