Postpartum Preeclampsia Care Using Point-of-Care Ultrasound and Diuretics

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This trial assesses a new approach to managing postpartum preeclampsia by using point-of-care ultrasound (POCUS) to gauge volume status and guide diuretic treatment. It includes historical and prospective cohorts to compare postpartum blood pressure control, length of hospital stay, and readmissions. The intervention combines a Butterfly iQ3 ultrasound assessment with oral or IV furosemide to target volume overload. Outcomes focus on blood pressure trajectory, diuretic use, and postpartum complications. The study is conducted at UC Irvine Medical Center with University of California, Irvine as the lead sponsor.

Why it matters

Who can join: the full rules

Inclusion Criteria:

Historical cohort (group 1):

* Age greater than or equal to 18 years at the time of delivery
* Diagnosis of preeclampsia (without severe features, with severe features, HELLP syndrome, eclampsia) during pregnancy
* Gestational age greater than or equal to 20 weeks' gestation at delivery
* Delivery at the study institution within the 18-month period prior to implementation of the study's POCUS intervention
* Available and complete postpartum clinical data on: Daily blood pressure, diuretic or antihypertensive use, length of postpartum hospital stay, readmission within 30 days of primary hospitalization

Prospective cohorts (groups 2 and 3):

* Age greater than or equal to 18 years at the time of enrollment
* Diagnosis of preeclampsia (without severe features, with severe features, HELLP syndrome, eclampsia) made up until 24 hours postpartum Postpartum and within 24 hours of delivery

Exclusion Criteria:

Historical cohort (group 1):

* Delivery at an outside facility or incomplete postpartum records available for analysis
* Pre-existing diagnosis of chronic hypertension; selected to mirror prospective cohort exclusion criteria (see below).
* Documentation of chronic kidney disease (CKD stage 3 or higher); selected because diuresis is more likely to be avoided in this patient population even in the presence of physical exam findings suggesting volume overload.
* Documentation of postpartum complications unrelated to preeclampsia that may significantly alter hemodynamics (e.g., sepsis, postpartum hemorrhage); selected because diuresis is more likely to be avoided in this patient population even in the presence of physical exam findings suggesting volume overload.

Prospective cohorts (groups 2 and 3):

* Pre-existing diagnosis of chronic hypertension; selected because previous studies on furosemide use in patients with postpartum preeclampsia have found a significant reduction in hypertension among patients with newly diagnosed hypertensive disorders of pregnancy, but not among those with pre-gestational hypertension, meaning that inclusion of this population might reduce the magnitude of study effects.
* Baseline renal dysfunction with serum creatinine \> 1.1 mg/dL; selected as this laboratory finding has been pre-selected as a safety outcome.
* Baseline hypokalemia with serum potassium \< 3.5 mEq/L despite previous repletion with intravenous or oral potassium chloride; selected as this laboratory finding has been pre-selected as a safety outcome.
* Known hypersensitivity to furosemide or sulfa drugs; selected because this would preclude exposure to the study medication of interest.
* Current use of diuretics for other indications (e.g. heart failure); selected because this may require a furosemide or other diuretic regimen different from that planned for the study intervention.

Where it's running

• University of California Irvine Medical Center
  Orange, California, United States Recruiting

Study contacts

• Principal investigator: Ashten B Waks, MD, MSPH — University of California, Irvine
• Study coordinator: Ashten B Waks, MD, MSPH
• Email: awaks@hs.uci.edu
• Phone: 714-456-2911

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.