Work

Evaluation of extravascular lung water and cardiac function by intrapartum bedside ultrasound: full-term preeclampsia vs. healthy controls

Year: 2026

Type: article

Abstract: Background Studies addressing full-term preeclampsia (PE) remain an area awaiting further exploration, and data concerning hemodynamic changes in women with PE during the initial 2 h postpartum remain elusive. This study aimed to observe the changes in extravascular lung water (EVLW), intravascular volume, and cardiac function in full-term PE before and after delivery and to investigate the differences in these parameters between PE patients and healthy women. Methods This was a prospective, observational study. A total of 16 women were included in the PE group, and 32 were included in the control group. Bedside ultrasound examinations were performed 24 h before delivery, 2 h after delivery, and 24 h after delivery. A semiquantitative assessment of EVLW was conducted via the 28-rib interspace technique to calculate the echo comet score (ECS). The inferior vena cava collapsibility index (IVC-CI), left ventricular ejection fraction, left atrial volume index, left ventricular E/A ratio, e-peak deceleration time, left ventricular index of myocardial performance (LIMP), right ventricular fractional area change, right atrial volume index, right ventricular E/A ratio, and right ventricular index of myocardial performance (RIMP) were calculated. Results ECS increased from 24 h before delivery to 2 h after delivery in both groups. From 2 to 24 h postpartum, only the control group presented a decrease in ECS. The ECS in the PE group remained consistently greater than that in the control group (all P < 0.001). The IVC-CI decreased in both groups from 24 h before delivery to 2 h after delivery and increased in both groups from 2 to 24 h postpartum, with the PE group showing a lower IVC-CI than that in the control group at 2 h postpartum ( P = 0.048). The LIMPs in the PE group were greater than those in the control group at 24 h before delivery ( P = 0.005), and the RIMPs in the PE group were greater than those in the control group at both 24 h before and 24 h after delivery ( P < 0.001, P = 0.011). Conclusions In this exploratory, hypothesis-generating study, EVLW and intravascular volume increased postpartum, with a greater increase observed in PE women, who also have a higher risk of pulmonary edema and a greater intravascular volume load. Intrapartum bedside ultrasound can be used for real-time monitoring of maternal EVLW, intravascular volume status, and cardiac function, aiding in the monitoring the condition and fluid management of PE patients.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2026.1709378

Authors: Shi-jie Zhang, Shao-zheng He, Jing-jing Wu, Yong-jian Chen, Guo-rong Lyu

Institutions: Fujian Medical University, Second Affiliated Hospital of Fujian Medical University, Quanzhou Medical College

Language: English

Topic: Pregnancy and preeclampsia studies

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801