Dr Janette Brohan

/ Dr Janette Brohan

Biography

Dr Janette Brohan is a medical graduate from University College Cork and an anaesthesia graduate from the College of Anaesthesiologists of Ireland. She has completed postgraduate fellowships in Cardiac Anaesthesia (Vancover General Hospital), Obstetric Anaesthesia (BC Women’s Hospital, Vancouver) and Intensive Care Medicine (Chelsea and Westminster Hospital, London).

In addition, she is qualified in Advanced Perioperative Transoesophageal Echocardiography, is an instructor and mentor in Focussed Intensive Care Echocardiography, and has developed a training course in focussed echocardiography for obstetric anaesthesiologists who are novices in echocardiography.

Her areas of interest include cardiac disease in the obstetric patient population and teaching focussed echocardiography. Janette works as a Consultant in Anaesthesia and Intensive Care Medicine in Cork University Hospital.

Abstract

Focused cardiac ultrasound (FoCUS) is a focused examination of the cardiovascular system performed by a physician using ultrasound as an adjunct to the physical examination to recognize specific ultrasonic signs that represent a narrow list of potential diagnoses in specific clinical settings1. This examination aims to evaluate, in a targeted and objective manner, a limited number of clinical issues such as the presence of hypovolaemia, ventricular dysfunction, pericardial effusion and significant valvular regurgitation2.

There has been a growing interest in the role of TTE in the obstetrics setting3-7. It has also been shown to be a valuable adjunct in the assessment of postpartum hypotension4, preeclampsia5 and peripartum cardiomyopathy6.

As the essence of the FoCUS examination is that it is a point-of-care examination, both education of clinicians and availability of equipment are essential. This presentation discusses the role of focussed echocardiography in the assessment and management of obstetric patients, in addition to the importance of educating obstetric anaesthesiologists in focussed echocardiography relevant to the obstetric patient.

  • Spencer KT et al. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2-13;26:567-81 (8)
  • Labovitz AJ et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr 2010;23:1225-30
  • Dennis AT. Transthoracic echocardiography in obstetric anaesthesia and obstetric critical illness. IJOA 2011;20:160-68
  • Dennis AT et al. The use of transthoracic echocardiography in postpartum hypotension. A&A 2012 (115) 5;1033-37
  • Dennis AT et al. Transthoracic echocardiography in women with treated severe pre-eclampsia. Anaesthesia 2014;69:436-44
  • Dennis AT et al. Echocardiographic differences between preeclampsia and peripartum cardiomyopathy. IJOA 2014;23:260-66
  • Armstrong S et al. Minimally- and non-invasive assessment of maternal cardiac output: go with the flow! IJOA 2011;20:330-40