الفهرس 
List of abbreviationsOnly 14 pages are availabe for public view
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Abstract
Severe preeclampsia is a hypertensive disease of pregnancy characterized by BP ≥160 / 110 with many other manifestations, severe headache, papilloedema, thrombocytopenia, pulmonary oedema, progressive renal impairment, or elevated liver enzymes.
Transthoracic echocardiography in ICU is a very helpful diagnostic tool that offer a great aid in the diagnosis of many disorders in critically ill patients (pulmonary embolism, ARDS, acute coronary syndrome, cardiac arrest, cardiac tamponade and haemodynamically unstable patients), in all these cases TTE offer a non-invasive rapid diagnosis but need a clinician with expertise in performing the procedure.
Lung ultrasonography provide an excellent tool for the diagnosis of many respiratory disorders in critically ill patients (pneumothorax, ARDS, pulmonary congestion, pulmonary consolidations). it is simple non invasive and could be repeated frequently to adjust fluid therapy.
This study was across sectional study conducted on 55 patients with severe PET, 35 patients with eclampsia and 60 pregnant women undergone C.S as a control group.
We found that there was no statistical difference between cases and control as regard age, while there was a statistically significant difference in BMI.
There was a statistically significant difference between cases and controls as regard gravidity and parity.
There was a statistically significant difference between cases and controls as regard pulse, blood pressure and type of anesthesia.
As regard TTE parameter we found a statistically significant difference between cases and controls in diastolic dysfunction, ejection fraction with no statistically significant difference in inferior vena cava diameter.
We found a statistically significant difference between cases and controls in fluid input and output, while as regard net balance there was no statistically significant difference between cases and controls.
There was a statistically significant difference between cases and control as regard lung ultrasound score.
We detect 8 types of compications (pulmonary oedema, ARDS, cardiac arrest, pericardial effusion, SAH, PRES, PPCM and pulmonary embolism) that occur in 10 patients (3 cases pulmonary oedema, 2 cases cardiac arrest, 2 case pericardial effusion and one case ARDS, one case has PRES then develop SAH (same case), and one case with PPCM then develop pulmonary embolism. (same case).
We found that cases with higher pulse rate (more than 100), higher lung ultrasound score (LUS score > 9), higher maternal age, higher grade of diastolic dysfunction (grade > 1) and lower ejection fraction have higher incidence of complications.
Conclusion and recommendations
The use of transthoracic echocardiography and lung ultrasonography is mandatory in postoperative monitoring in patients with severe PET and eclampsia as they can adjust management.
Restricted fluid therapy policy is indicated with the finding of B pattern especially with higher lung ultrasound score.
Early management in patients with high B line score (pulmonary congestion) even before development of clinical manifestations should be considered.
High maternal age, high pulse rate, higher grades of diastolic dysfunction, lower EF, and high LUS score all are predictors of complications in patients with severe PET and eclampsia and great attention with a close monitoring is indicated in these patients.
Incidence of complications was higher in eclamptic patients than those with severe PET. Patients with eclampsia with any of predictors of complications is considered a highly risk patient for complication.