Utility of two-dimensional echocardiography in pregnancy and post-partum period and impact on management in an inner city hospital
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Lekshmi Dharmarajan
Abstract
Aim: Evaluate the practice and appropriateness of requesting echocardiograms in patients with suspected or documented cardiac disease during gestation and puerperium, using the American College of Cardiology Foundation (ACCF) appropriateness criteria, in conjunction with clinical picture.
Methods: Retrospective observational study, to analyze echocardiograms performed during pregnancy and puerperium at a teaching hospital from 2001 to 2006 for appropriateness criteria and studying its impact on management. Sixty-seven patients pregnant or in the puerperal stage had an echocardiogram performed during that period; 58 met our criteria for inclusion.
Results: Based on clinical information and criteria of the ACCF, 51 of the 58 echocardiograms met the appropriateness criteria. Of the 51, results of 40 impacted on management; 14 of the 40 echocardiograms that had an impact were abnormal.
Conclusions: Although the ACCF appropriateness criteria have not been specifically studied in pregnancy, our study demonstrates that the criteria are applicable if used appropriately in pregnancy. Most indications in our study correlated with the appropriateness criteria. Although most findings were normal, information from echocardiograms impacted on management in the majority of patients, contributing to therapeutic decision-making. The reliability of echocardiograms performed according to appropriate criteria to assist clinical decisions was excellent even in patients with physiologic cardiovascular changes.
©2009 by Walter de Gruyter Berlin New York
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- Index - Authors
- Acknowledgement
- Acknowledgement
Artikel in diesem Heft
- Expert panel recommendation
- Delivery mode for the extremely premature fetus: a statement of the prematurity working group of the World Association of Perinatal Medicine
- Review articles
- The infant incubator in the neonatal intensive care unit: unresolved issues and future developments
- Survival and major disability rate in infant born at 22–25 weeks of gestation
- Original articles – Obstetrics
- Gene expression profiling of maternal blood in early onset severe preeclampsia: identification of novel biomarkers
- Risk assessment for preeclampsia in women with gestational diabetes mellitus
- Maternal serum adiponectin multimers in patients with a small-for-gestational-age newborn
- Maternal serum adiponectin multimers in gestational diabetes
- The effect of maternal obesity on the course of labor
- Decreased placental oxygenation capacity in pre-eclampsia: clinical application of a novel index of placental function preformed at the time of delivery
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- Original article – Fetus
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- Short communications
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- Obituary
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- Index Volume 37 (2009)
- Index Volume 37 (2009) - Contents
- Index - Subjects
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- Index - Authors
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- Acknowledgement
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