Pulmonary edema in pregnancy, a life threatening emergency: literature review

Document Type : Review Article

Authors

1 Assistant Professor, Department of Emergency Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Pulmonary edema is a dangerous complication of pregnancy. The prevalence of this emergency increases by some pregnancy complications like preeclampsia. Pulmonary edema can be categorized into two types of cardiogenic and noncardiogenic subtypes which each one has separate cause and treatment. This study was performed with aim to evaluate the pathophysiology of disease, factors involved in it, prevention and diagnosis and treatment of pulmonary edema in pregnancy.
Methods: In this review article, to find the relevant articles, we searched databases of PubMed, Cochrane, Embase, Goggle Scholar and Scopus using the keywords of  pulmonary edema, pregnancy, obstetrics, preeclampsia, fluid overload, cardiac failure, tocolytic therapy and pregnancy complication without time limitation up to 2015. 57 articles was selected and reviewed.
Results: Most important causes of pulmonary edema in pregnancy included tocolytic therapy, pre-existing cardiovascular disease, over hydration by intravenous fluid, preeclampsia and infections. Cardiogenic pulmonary edema is more prevalent than the noncardiogenic type in pregnant women and occurs more usually in the first days of postpartum period. The diagnostic tests for pulmonary edema are clinical symptoms, chest X ray and echocardiography. The treatment of this edema is ventilator support, blood pressure reduction by nitroglycerin and loop diuretics like furosemide. For non-cardiogenic pulmonary edema, the treatment consists of supportive measures and resolution of underlying disorder.
Conclusion: According to the mechanism of pulmonary edema, preventive measures are crucial in high risk patients. In cases of pulmonary edema, early prompt supportive cares and proper treatments can save the patient’s life.

Keywords

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 19, Issue 33
November 2016
Pages 15-22

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