title: Lung ultrasound-guided management of acute breathlessness during pregnancy.
abstract: Lung ultrasonography is a standard tool in the intensive care unit and in emergency medicine, but has not been described in the particular setting of the labour ward. During pregnancy, acute respiratory failure and pulmonary oedema are not uncommon life-threatening events. We present two case reports outlining the potential of lung ultrasonography in parturients. In case 1, lung ultrasonography allowed early diagnosis and treatment of acute dyspnoea in a parturient admitted for suspected asthma exacerbation. Lung ultrasonography revealed a 'B-pattern' of vertical lines radiating into the lung tissue, indicating severe pulmonary oedema complicating previously undiagnosed pre-eclampsia. In case 2, a pre-eclamptic patient was managed with combined transthoracic echocardiography and lung ultrasonography. The accuracy of lung ultrasonography in detecting interstitial oedema at a pre-clinical stage allowed adequate fluid resuscitation in this patient who had a high risk of alveolar pulmonary oedema. We believe that these cases strongly support the prospective validation of lung ultrasound for management of lung disorders in pregnant women.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, University Hospital of Marseille, Marseille, France. laurent.zieleskiewicz@ap-hm.fr
authors.forename: L
authors.initials: L
authors.lastname: Zieleskiewicz
authors.forename: D
authors.initials: D
authors.lastname: Lagier
authors.forename: C
authors.initials: C
authors.lastname: Contargyris
authors.forename: A
authors.initials: A
authors.lastname: Bourgoin
authors.forename: L
authors.initials: L
authors.lastname: Gavage
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Leone
mesh_terms: D000208:Acute Disease; D000328:Adult; D058109:Airway Management / Q000379:methods*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D010102:Oxygen Inhalation Therapy; D011225:Pre-Eclampsia / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D011507:Proteinuria / Q000150:complications; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000628:therapy; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy*; D012151:Resuscitation; D012640:Seizures / Q000209:etiology / Q000628:therapy; D055815:Young Adult
chemical_list: D004232:Diuretics; D005665:Furosemide