Sonographic evaluation of pulmonary interstitial edema in patients with preeclampsia

Our main purpose is to detect pulmonary edema, which is a major problem in preeclamptic pregnants, in the interstitial phase, sonographically. Our study was conducted prospectively between 01.09.2017-01.09.2019 in Abant Izzet Baysal University Obstetrics and Gynecology USA. Forty one patients (26 severe preeclampsia and 15 preeclampsia) diagnosed with preeclampsia according to ACOG (American College of Obsetricians and Gynecologist) and 21 healty control groups were evaluated. Lung ultrasonography and echocardiography examinations were performed to examine the signs of pulmonary loading before and after birth. In severe preeclampsia, the number of B lines before and after birth is statistically significant compared to other groups. However, there was no significant difference between preeclampsia and healthy control group pregnants in terms of pre-and post-natal B line. In addition, the total number of B lines calculated at 24 hours after delivery was significantly lower than that calculated before delivery (p <0.018). Prenatal E / e 'value in severe preeclampsia is significantly lower compared to preeclampsia and healthy control group pregnants. There was no significant difference between preeclampsia and healthy control group pregnants in terms of prenatal E / e value. In terms of prenatal E values, a statistically significant difference was found between all groups (p <0.001). A strong positive and statistically significant relationship was found between prenatal E / e' and B lines and prenatal E and B lines (r = 0.768, p <0.001, r = 0.820, p <0.001, respectively). The overall accuracy rate (AUC: Accuracy) of the prenatal E / e 'and E value for estimation of the B line number classification is 0.791 (95% CI: 0.674-0.908, p <0.001) and 0.829 (95% CI), respectively. 0.722-0.936, p <0.001). The optimum cut-off value for prenatal E / e 'is 6.95 (Sensitivity = 71.9%, Specificity = 80.0%), the optimum cut-off value for prenatal E values is 85.5 (Sensitivity) = 78.1% Specificity = 86.7%. In conclusion, pulmonary edema is a serious complication in patients with severe preeclampsia and may be detected interstitially in some patients, even if it does not occur clinically. Fluid restriction may be considered in these patients and patients at high risk of developing hypoxia can be closely monitored. Sonography is a useful method in the follow-up of pulmonary complications of preeclampsia patients, as it is an easily accessible and radiation-free examination.