{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:43:22Z","timestamp":1788327802449,"version":"build-2803163510"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Critically ill parturients have an increased risk of developing pulmonary complications. Lung ultrasound (LUS) could be effective in addressing the cause of respiratory distress in resource-limited settings with high maternal mortality. We aimed to determine the frequency, timing of appearance, and type of pulmonary complications in critically ill parturients in an obstetric unit in Sierra Leone. In this prospective observational study, LUS examinations were performed on admission, after 24 and 48 hours, and in case of respiratory deterioration. Primary endpoint was the proportion of parturients with one or more pulmonary complications, stratified for the presence of respiratory distress. Secondary endpoints included timing and types of complications, and their association with \u201cpoor outcome,\u201d defined as a composite of transfer for escalation of care or death. Of 166 patients enrolled, 35 patients (21% [95% CI: 15\u201328]) had one or more pulmonary complications, the majority diagnosed on admission. Acute respiratory distress syndrome (period prevalence 4%) and hydrostatic pulmonary edema (4%) were only observed in patients with respiratory distress. Pneumonia (2%), atelectasis (10%), and pleural effusion (7%) were present, irrespective of respiratory distress. When ultrasound excluded pulmonary complications, respiratory distress was related to anemia or metabolic acidosis. Pulmonary complications were associated with an increased risk of poor outcome (odds ratio: 5.0; 95% CI: 1.7\u201314.6; <jats:italic>P<\/jats:italic> = 0.003). In critically ill parturients in a resource-limited obstetric unit, LUS contributed to address the cause of respiratory distress by identifying or excluding pulmonary complications. These were associated with a poor outcome.<\/jats:p>","DOI":"10.4269\/ajtmh.20-0996","type":"journal-article","created":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T07:01:39Z","timestamp":1608015699000},"page":"478-486","source":"Crossref","is-referenced-by-count":25,"title":["Lung Ultrasound for Detection of Pulmonary Complications in Critically Ill Obstetric Patients in a Resource-Limited Setting"],"prefix":"10.4269","volume":"104","author":[{"given":"Luigi","family":"Pisani","sequence":"first","affiliation":[{"name":"1Department of Intensive Care, Amsterdam University Medical Centers\u2013Location AMC, Amsterdam, The Netherlands;"},{"name":"2Mahidol\u2013Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"De Nicolo","sequence":"additional","affiliation":[{"name":"3Intensive Care Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Schiavone","sequence":"additional","affiliation":[{"name":"4Thoracic Surgery Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetunji O.","family":"Adeniji","sequence":"additional","affiliation":[{"name":"5Princess Christian Maternity Hospital, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"De Palma","sequence":"additional","affiliation":[{"name":"4Thoracic Surgery Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Gennaro","sequence":"additional","affiliation":[{"name":"6Section of Operational Research, Doctors with Africa\u2013Cuamm, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Ejiro","family":"Emuveyan","sequence":"additional","affiliation":[{"name":"5Princess Christian Maternity Hospital, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Grasso","sequence":"additional","affiliation":[{"name":"3Intensive Care Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia C.","family":"Henwood","sequence":"additional","affiliation":[{"name":"7Department of Emergency Medicine, Thomas Jefferson University Hospitals, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alimamy P.","family":"Koroma","sequence":"additional","affiliation":[{"name":"5Princess Christian Maternity Hospital, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stije","family":"Leopold","sequence":"additional","affiliation":[{"name":"2Mahidol\u2013Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"},{"name":"8Department of Internal Medicine, Amsterdam University Medical Centers \u2013 Location AMC, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Marotta","sequence":"additional","affiliation":[{"name":"6Section of Operational Research, Doctors with Africa\u2013Cuamm, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Marulli","sequence":"additional","affiliation":[{"name":"4Thoracic Surgery Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Putoto","sequence":"additional","affiliation":[{"name":"6Section of Operational Research, Doctors with Africa\u2013Cuamm, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"Pisani","sequence":"additional","affiliation":[{"name":"5Princess Christian Maternity Hospital, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Russel","sequence":"additional","affiliation":[{"name":"9Department of Cardiology, Connaught Hospital, University of Sierra Leone, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ary","family":"Serpa Neto","sequence":"additional","affiliation":[{"name":"10Department of Critical Care Medicine, Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjen M.","family":"Dondorp","sequence":"additional","affiliation":[{"name":"2Mahidol\u2013Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"},{"name":"11Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Hanciles","sequence":"additional","affiliation":[{"name":"12Department of Anesthesia and Intensive Care, Connaught Hospital, University of Sierra Leone, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Koroma","sequence":"additional","affiliation":[{"name":"5Princess Christian Maternity Hospital, Freetown, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus J.","family":"Schultz","sequence":"additional","affiliation":[{"name":"1Department of Intensive Care, Amsterdam University Medical Centers\u2013Location AMC, Amsterdam, The Netherlands;"},{"name":"2Mahidol\u2013Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;"},{"name":"11Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom;"},{"name":"13Laboratory of Experimental Intensive Care and Anesthesiology (L\u00b7E\u00b7I\u00b7C\u00b7A), Amsterdam University Medical Centers \u2013 Location AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/2\/article-p478.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/2\/article-p478.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:51:19Z","timestamp":1612831879000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/2\/article-p478.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,3]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-0996","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,3]]}}}