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Initial experience with a hand-held device for transthoracic echocardiography in Labor & Delivery.
Abstract Number: F 57
Abstract Type: Case Report/Case Series
The ability to assess maternal cardiac status quickly, accurately and non-invasively on Labor & Delivery can prove invaluable in certain clinical situations. Since July 2012, we have utilized the Vscan Portable Ultrasound (GE Healthcare, Waukesha, WI) on our Labor & Delivery unit for basic transthoracic echocardiography.
By focusing on the left parasternal long and short axis views, which are relatively easy to obtain even in pregnancy, we have managed to collect data pertaining to maternal cardiac structure, fluid status, estimated cardiac output, and overall global function of the heart, including: 1) Reduced ventricular end-diastolic and end-systolic diameters during post-partum hemorrhage, which return towards normal after recovery; 2) Increase in cardiac output following Cesarean delivery and oxytocin administration; 3) Reduced ejection fraction in cardiomyopathy; 4) Left ventricular hypertrophy in a patient with pre-eclampsia and chronic hypertension; 5) Left atrial enlargement with mitral valve disease; 6) Normal anatomy.
While it may be too early to assess the impact such technology may have in guiding patient care in the long term, at minimum it has served as a valuable teaching tool for faculty, residents and medical students in our Obstetric and Anesthesia departments. Residents from both disciplines have learned to obtain the two basic views and make meaningful observations, suggesting that hand-held transthoracic ECHO may indeed be the “next stethoscope.”