(1024) Comparing inferior vena cava collapsibility in postpartum patients with and without severe preeclampsia

Friday, January 31, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Elsa Parra, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
University of Tennessee Health Science Center Memphis
Memphis, Tennessee, United States

Coauthor(s)

Kerri Brackney, MD

Assistant Professor of Obstetrics & Gynecology
University of Tennessee Health Science Center
Memphis, Tennessee, United States
LP

Lauren Piersall, MD

University of Tennessee Health Science Center
Memphis, Tennessee, United States
MV

Michael VanDillen, MD

PGY-5 MFM Fellow
University of Tennessee Health Science Center
Memphis, Tennessee, United States
PW

Paul J. Wendel, MD

Professor and Director of Division of Maternal Fetal Medicine
University of Tennessee Health Science Center
Memphis, Tennessee, United States
Angela Nakahara, MD

Maternal Fetal Medicine Fellow
University of Tennessee Health Science Center
Memphis, Tennessee, United States
MN

Meyer L. Norman, MD, PhD

Professor Obstetrics and Gynecology
University of Tennessee Health Science Center
Memphis, Tennessee, United States
PG

Patricia Goedecke, MS

Statistician
University of Tennessee Health Science Center
Memphis, Tennessee, United States

Objective: The aim of this study was to determine if there is a difference in the inferior vena cava collapsibility index (IVCCI) between postpartum patients with severe preeclampsia versus those without preeclampsia.

Study Design: This was a prospective cohort study conducted in an urban university teaching hospital from May 2024 to June 2024. Patients had singleton or twin gestations and were evaluated within 48 hours of delivery. Cases had severe features of preeclampsia and controls did not have preeclampsia. Patients who previously received furosemide, were hemodynamically unstable, or who had a postpartum hemorrhage were excluded. Inferior vena cava (IVC) diameter was measured at inspiration (IVCmin) and expiration (IVCmax) using transabdominal ultrasound with a curvilinear 1.5-5 Hz probe. The IVCCI was calculated ((IVCmax-IVCmin)/IVCmax). The primary outcome was the IVCCI in each group.

Results: Amongst cases, the median IVCCI was 0.27 (interquartile range = 0.14 to 0.37) while controls had a mean IVCCI of 0.28 (interquartile range = 0.19 to 0.37). There was no significant difference in the collapsibility index between those with severe preeclampsia and those without preeclampsia.

Conclusion: The IVCCI is an objective measure of intravascular volume. It was not shown to have a statistically significant difference between those with and without preeclampsia with severe features. A larger study cohort could establish a better understanding of IVC behavior in these two populations, and thus may provide a useful tool to guide fluid management and diuresis of postpartum patients with severe preeclampsia.