Hypertension in Pregnancy Clinical Trial
Official title:
SASH Study - Sonographic Assessment for Severe Hypertension in Pregnancy
• Adjunctive use of easily-obtainable maternal sonographic vascular measurements assessing volume status, cardiac output, and systemic vascular resistance by means of inferior vena cava collapsibility/caval index (ICV CI), end-point septal separation (EPSS) for determining left ventricular ejection fraction (LVEF), cardiac output determination (stroke volume x heart rate), stroke volume variation, & radial artery resistance index) augments standard vital sign assessment (pulse pressure and systolic / diastolic predominance) in clinical decision-making potentially leading to more appropriate pharmacologic and clinical therapies with faster resolution of severe hypertension among pregnant women and women in the postpartum period.
- Minutes count when it comes to treating and preventing serious complications associated
with hypertensive emergencies in pregnancy. The rates of maternal morbidity and
mortality are on the rise within the United States whereas the rates are falling in the
rest of the developed world. Cardiovascular and neurologic injury associated with the
severe hypertension witnessed among women with preeclampsia/eclampsia represent two of
the leading causes of maternal mortality within the U.S. Optimizing the clinical
identification and response to these perinatal complications represents one means of
reducing overall maternal mortality.
- Point-of-care use of ultrasound technology to augment clinical diagnosis and management
is gaining traction throughout nearly all fields of medicine. Obstetricians utilize this
technology frequently to assess the fetus and maternal-fetal interface, and our ability
to expand its use to assess a deeper understanding of maternal physiology is
underutilized. Exploration into the ability to apply clinically-proven point-of-care
sonographic techniques to augment maternal care and reduce maternal mortality is
warranted.
- The purpose of this study is to gain a deeper understanding of maternal physiologic
changes using easily-obtainable sonographic vascular measurements in the setting of
hypertensive emergencies and to assess the utility of these adjunctive maternal
sonographic measurements in augmenting clinical decision-making.
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