Point-of-Care Ultrasound in the Evaluation of Systolic Heart Failure During Pregnancy and Postpartum.

Abstract

Point-of-care ultrasound (POCUS) plays a central role in the evaluation of acute and chronic heart failure with reduced ejection fraction, yet its use in obstetric patients remains limited. This expert review outlines a simplified, qualitative-first approach tailored to the physiological 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, mitral annular plane systolic excursion, lung B-lines, and inferior vena cava diameter measurements. Most available data are extrapolated from nonpregnant 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. · Delayed recognition of systolic HF drives maternal morbidity and mortality.. · POCUS enables rapid bedside qualitative assessment when echo is delayed.. · With structured training, POCUS is feasible to support HF care in pregnancy..