Incidence of Postoperative Diaphragmatic Dysfunction in Pregnant Women With Preeclampsia With Severe Features Undergoing Cesarean Delivery: A Prospective Observational Study

Preeclampsia with severe features remains a leading contributor to maternal morbidity and mortality, particularly in low- and middle-income countries. It is defined by hypertension and involvement of multiple organ systems, including renal, hepatic, hematologic, and neurologic pathways. The interplay of endothelial dysfunction, capillary leakage, and disrupted fluid balance in these patients increases their susceptibility to perioperative pulmonary complications. Although respiratory complications in preeclampsia are clinically significant, the true incidence of postoperative diaphragmatic dysfunction in women with severe disease is not well established. Existing literature largely emphasizes general respiratory failure, pulmonary edema, or the need for mechanical ventilation, rather than specifically evaluating diaphragmatic performance with objective methods such as ultrasound. The current study sought to determine the incidence and identify risk factors for postoperative diaphragmatic dysfunction in women with severe preeclampsia following cesarean delivery.