Incidence of Postoperative Diaphragmatic Dysfunction in Pregnant Women With Preeclampsia

Incidence of Postoperative Diaphragmatic Dysfunction in Pregnant Women With Preeclampsia With Severe Features Undergoing Cesarean Delivery: A Prospective Observational Study

Preeclampsia with severe features remains a leading contributor to maternal morbidity and mortality, particularly in low- and middle-income countries. It is defined by hypertension and involvement of multiple organ systems, including renal, hepatic, hematologic, and neurologic pathways. The interplay of endothelial dysfunction, capillary leakage, and disrupted fluid balance in these patients increases their susceptibility to perioperative pulmonary complications. Although respiratory complications in preeclampsia are clinically significant, the true incidence of postoperative diaphragmatic dysfunction in women with severe disease is not well established. Existing literature largely emphasizes general respiratory failure, pulmonary edema, or the need for mechanical ventilation, rather than specifically evaluating diaphragmatic performance with objective methods such as ultrasound. The current study sought to determine the incidence and identify risk factors for postoperative diaphragmatic dysfunction in women with severe preeclampsia following cesarean delivery.

Study Overview

• Status: Recruiting
• Conditions: Preecalmpsia

• Study Type: Observational
• Enrollment (Estimated): 52

Contacts and Locations

• Study Contact: Name: Mina Adolf Helmy, MD; Phone Number: 01275716942; Email: minaadolf1988@cu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt
    • Recruiting
    • Cairo University Hospitals
    • Contact: Mina
    • Contact: Mina Adolf Helmy, MD; Phone Number: 01275716942; Email: minaadolf1988@cu.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This prospective observational study will enroll pregnant women aged 20-40 years present to the emergency department with a diagnosis of preeclampsia with severe features and are scheduled for cesarean delivery

Description

Inclusion Criteria:

• Patients with severe preeclampsia undergoing cesarean section
• Gestational age > 32 weeks

Exclusion Criteria:

• • Age < 20 years.

  • Diabetic
  • Patients with neuromuscular diseases.
  • Patient refusal.
  • Contraindications to magnesium sulphate administration
  • Inability to obtain adequate ultrasound views

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Preeclampsia with severe features; diaphragmatic excursion evaluation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The incidence of postoperative diaphragmatic dysfunction	diaphragmatic dysfunction is defined as a mean diaphragmatic excursion of less than 10 mm	Diaphragmatic excursion is measured before and 24 hours after surgery.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of change in DE	Percentage of change in diaphragmatic excursion from baseline to 24 hours after surgery	24 hours after surgery
Risk factors associated with postoperative diaphragmatic dysfunction	Regression analysis to detect risk factors	24 hours after surgery

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): March 9, 2026
• Primary Completion (Estimated): December 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: February 25, 2026
• First Submitted That Met QC Criteria: February 25, 2026
• First Posted (Actual): March 2, 2026

Study Record Updates

• Last Update Posted (Actual): March 11, 2026
• Last Update Submitted That Met QC Criteria: March 9, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: preeclampsia; Diaphragmatic dysfunction
• Additional Relevant MeSH Terms: Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Pregnancy Complications; Hypertension, Pregnancy-Induced; Pre-Eclampsia
• Other Study ID Numbers: N-62-2026

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No