Point-of-Care Ultrasound (POCUS) Exam Performed by an Anesthesiologist Changes Obstetric Management

TL;DR

An anesthesiologist used ultrasound to identify heart failure in a pregnant woman, leading to changes in her treatment and care.

Contribution

This case demonstrates the novel use of POCUS by anesthesiologists in managing antepartum patients with complex conditions.

Findings

POCUS identified new-onset systolic heart failure in a parturient with chronic hypertension.

POCUS findings led to inotropic therapy and diuresis, influencing the patient's transfer for advanced care.

The patient delivered via cesarean section and was successfully weaned off inotropes.

Abstract

Point-of-care ultrasound (POCUS) exams have been shown to impact perioperative patient care. Involvement in antepartum obstetric patients has not been previously described. We report a case of a parturient with chronic hypertension in new-onset respiratory distress. The anesthesiologist performed cardiac and lung POCUS exams that identified new-onset systolic heart failure and contributed to her diagnosis of preeclampsia with severe features. These findings guided the initiation of inotropic therapy and diuresis. The patient ultimately required transfer to a center able to perform more advanced obstetric and cardiac care, including extracorporeal membrane oxygenation (ECMO). The patient delivered via cesarean section under general anesthesia and was weaned off inotropes. This demonstrates how POCUS can guide the management of complex antepartum patients to change obstetric management.

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