Primary Study On Diagnosis Of Community Acquired Pneumonia By Lung Ultrasound In The Pregnant Patients

Objective:The diagnosis of community acquired pneumonia (CAP) is usually based on clinical manifestations, white blood cell count and chest X-ray. Lung ultrasound are typically not included in the diagnostic work-up of CAP with pregnancy. Recently, ultrasounds have been used extensively and successfully in the diagnosis of many kinds of lung diseases, but few studies of CAP with pregnancy. This study aimed to evaluate the value of lung ultrasound in the diagnosis of CAP with pregnancy.Method:It’s a prospective study allowed by the ethical committee and patients’relatives. From January1st to September30in2014, patients with gestational age>4weeks who admitted to the Emergency Department were enrolled in this observational and diagnostic study.45pregnant patients suspected pneumonia on the premise of informed consent,24hours after admission adept chest X-ray, lung ultrasound and blood routine examination. X-ray chest radiography inspection is report by qualified radiologists and lung ultrasound by trained emergency physicians or had qualifications of medical ultrasound check. Ultrasound inspectors would not be told to X chest X-ray report. The ultrasound report would not be informed patient’s doctor and does not affect the clinical treatment decisions. Quiet condition, patients with pregnancy take lie on her back, side or sitting position. With axillary front, axillary midline, after axillary line is bounded, the lung is divided into front, side and back three regions. The probe and vertical ribs respectively observed each area of bilateral lung scan, whether there is consolidation of the lung, A-line disappear, the mickle B-line appearance and lung pulse. Through the clinical symptoms, imaging, laboratory examination and treatment effect CAP were confirmed by two clinical competent physicians. The lung ultrasound imaging characteristics was analyzed in the pregnant patients with pneumonia. Drawing ROC curve by SPSS19.0, assessing the value of ultrasonic diagnosis of CAP, veried the lung ultrasonography and X-ray chest radiography in the diagnosis of CAP to the lungs Kappa inspection of the consistency.Result:(1) The total number of the patients involved in the study was45,45females, the mean age was28.0±2.54y, gestational age4weeks to12weeks20%(9/45),13weeks to27weeks46.7%(21/45),28weeks to40weeks33.3%(15/45), with pneumonia60%(27/45), without pneumonia40%(18/45). White blood cells in pneumonia group was significantly increased in control group(P<0.05), but age and gestational age not (P>0.05).(2) The ultrasound signs of lung consolidation, the mickle B-line appearance, A-line disappearance and lung pulse were not seen in the control group, respectively in the pneumonia group24lung consolidation(88.8%),27mickle B-line appearance (100%),27A-line disappearance(100%) and5lung pulse(27.8%)(p<0.001).(3) Both the sensitivity and specificity were100%when ultrasonic signs of lung consolidation, A-line disappearance and the mickle B-line appearance.Conclusion:LUS and X-ray chest radiography diagnostic consistency is good. LUS has characteristics of none radiation, convenient and feasible and repeatable. It can be used for the diagnosis of patients suspected pneumonia with pregnant women.