This expert review provides a tailored framework for using point-of-care ultrasound to evaluate suspected systolic heart failure in obstetric patients.
Point-of-care ultrasound (POCUS) plays a central role in the evaluation of acute and chronic heart failure with reduced ejection fraction (HFrEF), yet its use in obstetric patients remains limited. This expert review outlines a simplified, qualitative-first approach tailored to the physiologic and technical challenges of pregnancy. We present a step-by-step guide that prioritizes feasibility and reproducibility using simple and established echocardiographic views including the E-Point Septal Separation (EPSS), Mitral Annular Plane Systolic Excursion (MAPSE), lung B-lines, and IVC diameter measurements. Most available data are extrapolated from non-pregnant cohorts, and pregnancy-specific outcome evidence remains limited. This framework aims to support maternal-fetal medicine specialists in integrating POCUS into the bedside evaluation of pregnant individuals with suspected systolic heart failure.
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