In high-income countries, cardiovascular disease is the leading cause of maternal
death,
1
and the incidence of postpartum hemorrhage continues to increase.
- Dawson A.J.
- Krastev Y.
- Parsonage W.A.
- et al.
Experiences of women with cardiac disease in pregnancy: a systematic review and metasynthesis.
BMJ Open. 2018; 8e022755https://doi.org/10.1136/bmjopen-2018-022755
2
Point-of-care ultrasonography (POCUS) has emerged as a valuable tool in the assessment
of high-risk obstetric patients and women who experience bleeding or other complications
during childbirth. The increasing burden in morbidity and obstetric critical illness
over recent decades has led anesthesia experts to advocate for the use of POCUS on
all high-acuity obstetric units.
3
With the advent of smaller and more affordable ultrasound machines
4
, the availability of ultrasound devices has increased, making POCUS no longer a skill
confined to cardiologists and radiologists.
5
Point-of-care ultrasonography has become an effective tool for guiding invasive procedures
and supporting peri-operative decision making in all phases of clinical care and many
settings.
6
,
7
Furthermore, focused cardiac ultrasound (FCU) has been proven effective to guide
volume resuscitation, assess cardiac contractility, identify gross valvular abnormalities
or pericardial effusion.
8
As a non-invasive diagnostic tool, POCUS offers a significant potential benefit in
the obstetric environment where the clinical status of a previously healthy parturient
can change rapidly and unexpectedly.
9
Focused cardiac ultrasound is also useful on a labor and delivery floor (for example
to identify the underlying source of acute dyspnea and arterial hypotension at the
bedside) where cardiology or radiology consultations are rarely available after hours.
8
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References
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MBRRACE-UK_Maternal_Report_2021_-_FINAL_-_WEB_VERSION.pdf, https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2021/MBRRACE-UK_Maternal_Report_2021_-_FINAL_-_WEB_VERSION.pdf.
Article info
Publication history
Published online: March 22, 2022
Accepted:
March 18,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
