Thoracic Ultrasonography for Pulmonary Edema in Patients With Pre-Eclampsia

May 3, 2017 updated by: Antonios Likourezos

Thoracic Ultrasonography for the Assessment of Pulmonary Edema in Patients With Pre-Eclampsia

This project will study the use of ultrasound of the chest for the detection of fluid in the lungs in patients with pre-eclampsia vs pregnant patients without pre-eclampsia. Pre-eclampsia is a syndrome usually diagnosed in the second half of pregnancy in which patients develop elevated blood pressure and may develop protein in their urine, neurologic abnormalities, fluid in the lungs, and abnormal blood tests associated with the liver and kidney. Pulmonary edema (fluid in the lungs) in pre-eclampsia can lead to patient discomfort and significant morbidity and mortality. It can be detected using chest x-ray, although this type of imaging offers significant disadvantages, including radiation, which is of particular concern in pregnant patients. In addition, previous studies have demonstrated that chest x-ray is not very accurate in the detection of fluid in the lungs. Multiple previous studies have demonstrated the utility of chest ultrasonography in detecting fluid in the chest, although the vast majority of these studies involved patients with acute decompensated heart failure. Our goal is to evaluate bedside ultrasound of the chest in patients with pre-eclampsia in comparison to normal pregnant patients to determine whether these patients have abnormal fluid in the chest.

The investigators will divide our patients into two groups. In the study group, the investigators will include patients with pre-eclampsia with or without shortness of breath, and in the control group, the investigators will include pregnant patients without pre-eclampsia. Informed consent will be obtained from all patients enrolled in the study. These patients will then undergo an ultrasound of the chest, performed by a member of the Emergency Medicine Ultrasound Division. The images will be transmitted wirelessly from the ultrasound machine to a secure web based cloud (Q-path) and will be subsequently reviewed by expert reviewers.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This project will compare the use of ultrasound of the chest for the detection of fluid in the lungs in patients with pre-eclampsia vs pregnant patients without pre-eclampsia. Patients admitted to the obstetrical service will be recruited for study enrollment. We will divide our patients into two groups. In the study group, we will include patients with pre-eclampsia with or without shortness of breath, and in the control group, we will include otherwise healthy pregnant patients. We will exclude patients who are in labor or who are undergoing induction. Informed consent will be obtained from all patients enrolled in the study.

Study subjects will then undergo an ultrasound of the chest, performed by a member of the Emergency Medicine Ultrasound Division, who have experience in performing lung ultrasounds. Both hemithoraces will be divided into 4 zones: anterior inferior, anterior superior, lateral inferior, and lateral superior. Each zone will be assessed for the presence of B-lines. For a zone to be considered "positive" for pulmonary edema, there should to be a minimum of 3 B-lines. To diagnose a patient with pulmonary edema, at least two zones in both hemithoraces must be positive. The study investigator will document the presence of B-lines in each particular zone on the data collection sheet. Brief representative video clips will be recorded for each zone.

After completing the sonographic examination, the images will be transmitted wirelessly from the ultrasound machine to a secure web based cloud (Q-path) and will be subsequently interpreted by expert reviewers who will be blinded to any clinical information about the patient. They will also document their findings on a separate data collection sheet.

Study Type

Observational

Enrollment (Actual)

186

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • Brooklyn, New York, United States, 11219
        • Maimonides Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 55 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

Pregnant Females

Description

Inclusion Criteria:

  • Age 18+ years of age
  • Met criteria for pre-eclampsia as per ACOG guidelines for the study group
  • Consent to participate in study
  • Single intrauterine pregnancy

Exclusion Criteria:

  1. Other cardiovascular or pulmonary problems
  2. Other obstetrical or uteroplacental problems - abruption placenta, coagulopathy, immunological disorders.
  3. Patients who are in labor or are received induction medications such as Pitocin.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
pre-eclampsia
Ultrasound of Pregnant Females 18+ with pre-Eclampsia
Device: Ultrasound
Ultrasound of the chest for the detection of fluid in the lung
No pre-eclampsia.
Ultrasound of Pregnant Females 18+ with no pre-eclampsia
Device: Ultrasound
Ultrasound of the chest for the detection of fluid in the lung

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Detection of Fluid in the Lungs
Time Frame: 24-36 weeks
Detection of Fluid in the lungs in patients with pre-eclampsia vs. pregnant patients without pre-eclampsia
24-36 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Antonios Likourezos

Investigators

  • Principal Investigator: Eitan Dickman, MD, Maimonides Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

February 1, 2015

Primary Completion (Actual)

January 1, 2017

Study Completion (Actual)

January 1, 2017

Study Registration Dates

First Submitted

January 31, 2015

First Submitted That Met QC Criteria

February 5, 2015

First Posted (Estimate)

February 6, 2015

Study Record Updates

Last Update Posted (Actual)

May 15, 2017

Last Update Submitted That Met QC Criteria

May 3, 2017

Last Verified

September 1, 2016

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2014-11-25

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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