Prospective analytical study on acute pulmonary edema in obstetric intensive care unit

Prasanna Nagaraj; Harilakshmi Meganathan

doi:10.18203/2320-1770.ijrcog20194379

Authors

Prasanna Nagaraj Department of Obstetrics and Gynecology, Mahathma Gandhi Memorial Government Hospital, Trichy, Tamil Nadu, India
Harilakshmi Meganathan Department of Obstetrics and Gynecology, Mahathma Gandhi Memorial Government Hospital, Trichy, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20194379

Keywords:

Acute pulmonary edema, Heart disease, Severe preeclampsia

Abstract

Background: Acute pulmonary oedema is an uncommon,but life threatening event in pregnancy. It causes significant morbidity and mortality due to pathophysiology of pre‐eclampsia and physiological changes of pregnancy which may aggravate certain pre-existing heart disease.

Methods: This study was conducted to describe the clinical and epidemiological profile of antenatal women with acute pulmonary edema in obstetric ICU from January 2017 to December 2018 (2 years) in Mahathma Gandhi Memorial Government Hospital, Trichy, Tamil Nadu, India.

Results: Acute pulmonary edema (n=31) accounts for 2.7% of ICU/HDU admissions in the study period. Most common etiology observed was severe preeclampsia (12 cases) followed by cardiogenic pulmonary edema (11 cases). Fluid overload, sepsis accounted for 7 cases and one mother with preexisting RHD had severe pre-eclampsia with acute pulmonary edema.

Conclusions: Hypertensive disorders of pregnancy and heart disease contributes to major proportion of acute pulmonary edema in this study and it is imperative to recognize signs of critical illness. Skilled multidisciplinary teamwork plays an important role in optimizing maternal and fetal health.

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Author Biography

Prasanna Nagaraj, Department of Obstetrics and Gynecology, Mahathma Gandhi Memorial Government Hospital, Trichy, Tamil Nadu, India

References

Farrer J, Sullivan JT. Pulmonary edema in pregnancy maternal medicine, Editors, Luis D. Pacheco, Saade GR, Gary DV Hankins, 2015;8:848-874.

Narendra DK, Muigai D, Guntupalli KK. Acute Respiratory Distress Syndrome in pregnancy, Critical care obstetrics, Phelan JP, 6th edition, 2019:403-418.

Cunningham FG, Leveno KJ, Bloom SL, Critical care and Trauma, Williams Obstetrics, 25th edition, chapter 47; 2018:2028-2075.

Deen J, Chandrasekaran S, Stout K. Heart disease in pregnancy, Gabbe Obstetrics, Normal and Problem pregnancies, 7th edition, chapter 37. 2017:803-842.

Habli M, Bombrys A, Barton JR. Etiology and management of acute pulmonary edema in pregnancy-postpartum: Role of echocardiography. Am J Obstet Gynaecol. 2007;197(6):117.

Sciscione AC, Ivester T, Largoza M. Acute pulmonary edema in pregnancy. Obstet Gynaecol. 2003;101(3):511-5.

Dennis AT, Solnordal CB. Acute pulmonary oedema in pregnant women, perioperative medicine. Critical Pain. 2012;67(6):646-59.

Bourjeily G, Khalil H, Paglia MJ. Approach to shortness of breath in pregnancy, De sweits medical disorder in practice, 5th edition. 2010:689-694.

Pordeus, Ana Carolina B, Katz, L. Acute pulmonary edema in an obstetric intensive care unit, A case series study, Medicine (Baltimore), Section Editors: Wane, Daryl, 2018;97(28):e11508.

Wardhana MP, Dachlan EG, Dekker G. Pulmonary edema in preeclampsia: an Indonesian case-control study, J Maternal-Fetal Neonatal Med. 2018;31(6):689-95.

Gandhi S, Sun D, Park AL, Hladunewich M. The pulmonary edema preeclampsia evaluation (pepe) study. J Obstet Gynaecol Canada. 2014;36(12):1065-70.

Katz L, Barbosa AC, Pordeus. 118 Clinical and epidemiological profile of obstetrics patients with hypertensive acute pulmonary edema hospitalized in a intensive care unit: Medical complications of pregnancy related to hypertensive syndromes. Pregnancy Hypertension. Int J Women's Cardio Health, 2016;6(3):236-7.