POCUS can be a valuable tool in the assessment and management of critically ill pregnant patients.
Conditions to consider in the critically ill pregnant patient who presents with acute RUQ pain include acute fatty liver of pregnancy (AFLP), liver infarction, liver hematoma, and Budd-Chiari Syndrome.
POCUS findings for these conditions include:
AFLP: a "bright" liver
Infarction: a wedge-shaped hypoechoic area (late finding)
Hematoma: a heterogeneous fluid collection below the capsule or intraparenchymal
Budd-Chiari Syndrome: lack of blood flow or thrombus in a hepatic vein or within the IVC.
References
Blanco P, Abdo-Cuza A. Point-of-care ultrasound in the critically ill pregnant or postpartum patient: what every intensivist should know. Intensive Care Med. 2019; epub ahead of print.
