Pulmonary ultrasound can be used to exclude pulmonary pathology in
pregnancy: a prospective controlled study.
Abstract
Objective: To evaluate and validate the specificity of pulmonary
ultrasound as a diagnostic tool for pleural effusion, pneumonia and
pulmonary oedema in healthy pregnant women compared to non-pregnant
healthy women. Design: Single-centre, prospective, observational
controlled study. Setting: Large teaching hospital in the Netherlands.
Population: All women underwent pulmonary ultrasound evaluation. We
included 127 pregnant and 124 non pregnant women. Methods: Pulmonary
ultrasound was performed in both pregnant and non-pregnant women.
Presence and/of symptoms of pulmonary or cardiovascular pathology and
≤20 weeks of pregnancy were among the exclusion criteria. Pulmonary
ultrasound was performed by following the BLUE-protocol. Main outcome
measures: The following items were assessed: A-lines, B-lines, comet
tails, pleural effusion, sub pleural consolidation and hepatization.
Presence of three or more B-lines, pleural effusion and/or sub pleural
consolidation was interpreted as a false positive outcome after review
of an expert. Results: We included 251 patients, who underwent pulmonary
ultrasound evaluation. None of the participants showed pleural effusion,
sub pleural consolidation or hepatization. One participant showed
presence of >3 B-lines. One ultrasound showed a spine sign.
Thus, two of the pulmonary ultrasounds was considered false positive.
Conclusions: In this study no differences in specificity of pulmonary
ultrasound were found in healthy pregnant women compared to healthy
non-pregnant women. This suggests translatability of pulmonary
ultrasound studies to the pregnant population for the evaluation of
respiratory complaints.