Evaluation of Electrical Velocimetry for Assessment of Extra-vascular Lung Water in Pre-eclamptic Patients

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to compare the sensitivity and the specificity of electrical cardiometry to the lung ultrasound in measuring thoracic lung water in pregnant females with pre-eclampsia. If electrical cardiometry is validated against ultrasound, it will be easy to use with numerical number that will not require advanced experience as with the ultrasound.

Detailed Description
-----------------
Pre-eclampsia is accompanied with increased risk of serious complications such as pulmonary edema, cerebrovascular accidents, coagulopathy, and hemorrhage. Pre-eclampsia is responsible for 46.6% of the etiology of acute pulmonary edema in pregnant women. Fluid management in pre-eclamptic patients is challenging. Hypovolemia exacerbates organ failure, whereas volume overload results in pulmonary edema. Thus, using different methods for evaluation of volume status of the patients would improve patient management. Lung ultrasound has been developed as an accurate non-invasive method for assessment of extra-vascular lung water; However, ultrasound needs skilled operator. Electrical velocimetry (cardiometry) is a newer technology for assessment of total thoracic fluid content (TFC); however, it has not been validated in pre-eclamptic patients. In this study the investigators will validate the accuracy of cardiometry in evaluation of lung water using the lung ultrasound as a gold standard. Both methods will be evaluated for prediction of the need of diuretic therapy and the need for post-operative oxygen therapy.

Official Title
-----------------
Evaluation of Electrical Velocimetry for Assessment of Extra-vascular Lung Water in Pre-eclamptic Patients

Conditions
-----------------
Pre-Eclampsia

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: pregnant pre-eclamptic In first stage of labor Exclusion Criteria: Eclampsia. Second, third and fourth stages of labor on admission. Patients with severe cardiac and/or pulmonary disease.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total thoracic fluid content | total fluid content measured by electrical velocimetry device (cardiometry) | after 30 minutes from patient admission to the obstetric casuality | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The need of diuretics | The presence of lung congestion manifested by respiratory distress (dyspnea, tachypnea, and decreased oxygen saturation below 90%) needing intravenous diuretics | during the period starting from admission till one day after delivery | 
| extra-vascular lung water | extra-vascular lung water measured by ultrasound (lung ultrasound score) | after 30 minutes from patient admission to the obstetric casuality | 
| lung congestion | the presence of lung congestion manifested by audible crepitations by chest auscultation | during the period starting from admission till one day after delivery | 
| serum albumin | the level of albumin in blood (measured by g/ liter | after 30 minutes from patient admission to the obstetric casuality | 
| arterial blood pressure | arterial blood pressure measured in mmHg | after 30 minutes from patient admission to the obstetric casuality | 
| heart rate | the number of heart beats per minute | after 30 minutes from patient admission to the obstetric casuality |