Ultrasonography For Fluid Assessment in Parturients with Preeclampsia Undergoing Elective Cesarean Section Under Spinal Anesthesia

Background: Preeclampsia is a syndrome characterized by hypertension and organ system involvement. Fluid assessment is essential to avoid complications. Point of care ultrasonography (POCUS) is noninvasive tool used in assessment of parturients with preeclampsia. Objective: This study evaluated perioperative ultrasonography for assessment of lung congestion, optic nerve sheath diameter (ONSD), and IVC diameters in parturients with preeclampsia. We hypothesized a difference in pulmonary congestion over time during cesarean delivery.
Patients and methods: This was a prospective observational study of one hundred ASA II-III parturients with preeclampsia, singleton pregnancy undergoing elective cesarean delivery under spinal anesthesia. Lung ultrasonography, IVC diameters and ONSD ultrasound performed at baseline, at 1 h and 2 h after spinal anesthesia, Lung ultrasound for quantification of the Echo Comet Score (ECS). The maximum and minimum IVC diameters assessed using the subcostal long-axis view. ONSD measured 3 mm behind the globe.
Results: No significant difference in the ECS and ONSD at 1 hour and 2 hours compared with baseline (P=0.46), (P=0.16) respectively. The maximum and minimum IVC diameters were larger at 1 h and 2 h compared with baseline (P<0.0001).There was a positive correlation between the ECS and ONSD at 2 h. (r² = 0.689, P<0.001).
Conclusion: No significant difference in the ECS and ONSD at 1 hour and 2 hours after spinal anesthesia compared with baseline. Non-invasive POCUS used for fluid assessment in parturients with preeclampsia.