Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound
Abstract Background Healthy parturients may experience pulmonary edema and disturbed cardiac function during labor. We aimed to evaluate the extravascular lung water (EVLW), intravascular volume, and cardiac function of normal parturients during spontaneous vaginal delivery by bedside ultrasound. An...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-023-06201-4 |
| _version_ | 1797362787414966272 |
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| author | Shi-jie Zhang Shao-zheng He Jing-jing Wu Yong-jian Chen Guo-rong Lyu |
| author_facet | Shi-jie Zhang Shao-zheng He Jing-jing Wu Yong-jian Chen Guo-rong Lyu |
| author_sort | Shi-jie Zhang |
| collection | DOAJ |
| description | Abstract Background Healthy parturients may experience pulmonary edema and disturbed cardiac function during labor. We aimed to evaluate the extravascular lung water (EVLW), intravascular volume, and cardiac function of normal parturients during spontaneous vaginal delivery by bedside ultrasound. And to explore the correlation between EVLW and intravascular volume, cardiac function. Methods This was a prospective observational study including 30 singleton-term pregnant women undergoing spontaneous vaginal delivery. Bedside ultrasound was performed at the early labor, the end of the second stage of labor, 2 and 24 h postpartum, and 120 scanning results were recorded. EVLW was evaluated by the echo comet score (ECS) obtained by the 28-rib interspaces technique. Inferior vena cava collapsibility index (IVC-CI), left ventricle ejection fraction, right ventricle fractional area change, left and right ventricular E/A ratio, and left and right ventricular index of myocardial performance (LIMP and RIMP) were measured. Measurements among different time points were compared, and the correlations between ECS and other measurements were analyzed. Results During the spontaneous vaginal delivery of healthy pregnant women, 2 had a mild EVLW increase at the early labor, 8 at the end of the second stage of labor, 13 at 2 h postpartum, and 4 at 24 h postpartum (P < 0.001). From the early labor to 24 h postpartum, ECS first increased and then decreased, reaching its peak at 2 h postpartum (P < 0.001). IVC-CI first decreased and then increased, reaching its minimum at the end of the second stage of labor (P < 0.001). RIMP exceeded the cut-off value of 0.43 at the end of the second stage of labor. ECS was weakly correlated with IVC-CI (r=-0.373, P < 0.001), LIMP (r = 0.298, P = 0.022) and RIMP (r = 0.211, P = 0.021). Conclusions During spontaneous vaginal delivery, the most vital period of perinatal care is between the end of the second stage of labor and 2 h postpartum, because the risk of pulmonary edema is higher and the right ventricle function may decline. IVC-CI can be used to evaluate maternal intravascular volume. The increase in EVLW may be related to the increase in intravascular volume and the decrease in ventricular function. |
| first_indexed | 2024-03-08T16:12:27Z |
| format | Article |
| id | doaj.art-8cc7539c8d024359ae3fb9e88bdd846f |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-08T16:12:27Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-8cc7539c8d024359ae3fb9e88bdd846f2024-01-07T12:53:16ZengBMCBMC Pregnancy and Childbirth1471-23932024-01-0124111010.1186/s12884-023-06201-4Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasoundShi-jie Zhang0Shao-zheng He1Jing-jing Wu2Yong-jian Chen3Guo-rong Lyu4Department of Ultrasound, Second Affiliated Hospital of Fujian Medical UniversityDepartment of Ultrasound, Second Affiliated Hospital of Fujian Medical UniversityDepartment of Obstetrics and Gynecology, Second Affiliated Hospital of Fujian Medical UniversityDepartment of Ultrasound, Second Affiliated Hospital of Fujian Medical UniversityDepartment of Ultrasound, Second Affiliated Hospital of Fujian Medical UniversityAbstract Background Healthy parturients may experience pulmonary edema and disturbed cardiac function during labor. We aimed to evaluate the extravascular lung water (EVLW), intravascular volume, and cardiac function of normal parturients during spontaneous vaginal delivery by bedside ultrasound. And to explore the correlation between EVLW and intravascular volume, cardiac function. Methods This was a prospective observational study including 30 singleton-term pregnant women undergoing spontaneous vaginal delivery. Bedside ultrasound was performed at the early labor, the end of the second stage of labor, 2 and 24 h postpartum, and 120 scanning results were recorded. EVLW was evaluated by the echo comet score (ECS) obtained by the 28-rib interspaces technique. Inferior vena cava collapsibility index (IVC-CI), left ventricle ejection fraction, right ventricle fractional area change, left and right ventricular E/A ratio, and left and right ventricular index of myocardial performance (LIMP and RIMP) were measured. Measurements among different time points were compared, and the correlations between ECS and other measurements were analyzed. Results During the spontaneous vaginal delivery of healthy pregnant women, 2 had a mild EVLW increase at the early labor, 8 at the end of the second stage of labor, 13 at 2 h postpartum, and 4 at 24 h postpartum (P < 0.001). From the early labor to 24 h postpartum, ECS first increased and then decreased, reaching its peak at 2 h postpartum (P < 0.001). IVC-CI first decreased and then increased, reaching its minimum at the end of the second stage of labor (P < 0.001). RIMP exceeded the cut-off value of 0.43 at the end of the second stage of labor. ECS was weakly correlated with IVC-CI (r=-0.373, P < 0.001), LIMP (r = 0.298, P = 0.022) and RIMP (r = 0.211, P = 0.021). Conclusions During spontaneous vaginal delivery, the most vital period of perinatal care is between the end of the second stage of labor and 2 h postpartum, because the risk of pulmonary edema is higher and the right ventricle function may decline. IVC-CI can be used to evaluate maternal intravascular volume. The increase in EVLW may be related to the increase in intravascular volume and the decrease in ventricular function.https://doi.org/10.1186/s12884-023-06201-4EchocardiographyLung ultrasoundLaborCardiac functionPulmonary edema |
| spellingShingle | Shi-jie Zhang Shao-zheng He Jing-jing Wu Yong-jian Chen Guo-rong Lyu Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound BMC Pregnancy and Childbirth Echocardiography Lung ultrasound Labor Cardiac function Pulmonary edema |
| title | Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| title_full | Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| title_fullStr | Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| title_full_unstemmed | Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| title_short | Evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| title_sort | evaluation of extravascular lung water and cardiac function in normal vaginal delivery by intrapartum bedside ultrasound |
| topic | Echocardiography Lung ultrasound Labor Cardiac function Pulmonary edema |
| url | https://doi.org/10.1186/s12884-023-06201-4 |
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