The Use of Transthoracic Echocardiography in Postpartum Hypotension

• Volume 115 • Number 5 www.anesthesia-analgesia.org 1033 A 29-year-old primiparous woman, with no significant medical history, presented to our institution with an antepartum hemorrhage and underwent an uncomplicated cesarean delivery, with minimal blood loss, under spinal anesthesia at 35 weeks’ gestation. She was hemodynamically stable until 6 hours after delivery when she became hypotensive, tachycardic, and febrile. Despite fluid resuscitation, a hemoglobin level of 122 g/dL, vasopressors, and broad-spectrum IV antibiotics, she remained hypotensive and there was diagnostic uncertainty as to the cause of her hypotension. The anesthesiologist trained in transthoracic echocardiography (TTE) performed the Rapid Obstetric Screening Echocardiography (or ROSE) scan.1 Qualitative assessment of cardiac function obtained from the parasternal