Lung Ultrasound to Detect Pulmonary Complications in Critically Ill Parturients
Lung Ultrasound to Detect Pulmonary Complications in Critically Ill Parturients
This study aims at describing the frequency, timing and type of pulmonary complications
 detected with lung ultrasound in critically-ill parturients in admitted to a high-dependency
 unit in Freetown, Sierra Leone.
Rationale: The three big 'killers' in parturients, peripartum hemorrhage, sepsis and
 pre-eclampsia all predispose to pulmonary complications. These complications affect
 management before, during and after the primary obstetric problem has been solved. A timely
 diagnosis and thorough follow-up of pulmonary complications may benefit parturients. Lung
 ultrasound (LUS) is a point-of-care imaging bedside tool increasingly used in the critical
 care setting that may prove useful in parturients.

 Objective: To describe frequency, timing and type of pulmonary complications detected with
 LUS in critically ill parturients in a high-dependency unit (HDU), and to determine the
 association with outcome.

 Hypotheses: Pulmonary complications detected by LUS are frequent in parturients admitted to a
 HDU in a resource-limited setting, and are associated with hospital mortality.

 Study design: A prospective observational study. Study population: Critically ill parturients
 admitted to the HDU of the Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra
 Leone.

 Sample size: No formal sample size calculation is performed. Based on current rates of
 admissions to the HDU of the PCMH the investigators expect to perform LUS in at least 125
 patients.

 Methods: A trained physician performs all 12-region LUS investigations. LUS is performed at
 admission, after 24 and 48 hours, and when a patient's respiratory condition deteriorates.
 LUS findings are reported using a standardized semi-quantitative visual LUS scoring method.

 Main study parameters/primary endpoints: The proportion of critically ill parturients
 admitted to the HDU of the PCMH with pulmonary complications detected by LUS, including
 interstitial syndrome, pulmonary consolidation, and pleural effusion.
Inclusion Criteria:

 -  Admitted to the HDU of the PCMH during the study period

 -  Verbal informed consent of the patient or his/her formal representative

 Exclusion Criteria:

 -  Lung ultrasound not feasible, e.g., due to electricity breakdown, or absence of the
 trained sonographer.