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Acute postpartum pulmonary edema in a 23-year-old woman 5 days after cesarean delivery

Published online by Cambridge University Press:  21 May 2015

Caitlin Dunne  and
Antonio Meriano
Caitlin Dunne*
Affiliation:
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC
Antonio Meriano*
Affiliation:
Department of Emergency Medicine, Windsor Regional Hospital, Windsor, Ont. Emergency Medicine, South Western Ontario Medical Education Network, Schulich School of Medicine, University of Western Ontario, London, Ont.
*
Emergency Department, Windsor Regional Hospital, 1995 Lens Ave., Windsor ON N8W 1L9; [email protected]
Emergency Department, Windsor Regional Hospital, 1995 Lens Ave., Windsor ON N8W 1L9; [email protected]

Abstract

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The presentation of acute dyspnea after pregnancy is rare, but should bring a number of important conditions to the mind of the attending physician. Pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary edema are some of the potentially devastating causes that must be considered. The percentage of pregnancies that are complicated by acute pulmonary edema has been estimated to be 0.08%. The most common contributing factors include the administration of tocolytic agents, underlying cardiac disease, iatrogenic fluid overload and preeclampsia. No matter what the underlying pathology, prompt administration of appropriate resuscitation is always the first priority. Only after the patient has been stabilized can attention be turned to diagnosis and specific treatment. This case examines one such presentation and reviews some of the diagnostic possibilities.

Keywords

emergency medicinepulmonary edemaobstetric emergencies
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 2 , March 2009 , pp. 178 - 181
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

1.Demakis, JG, Rahimtoola, SH, Sutton, GC, et al. Natural course of peripartum cardiomyopathy. Circulation 1971;44:1053–61.Google Scholar
2.Cunningham, FG, Pritchard, JA, Hankins, GD, et al. Peripartum heart failure: Idiopathic cardiomyopathy or compounding cardiovascular events? Obstet Gynecol 1986;67:157–68.CrossRefGoogle ScholarPubMed
3.Sliwa, K, Damasceno, A, Mayosi, BM. Epidemiology and etiology of cardiomyopathy in Africa. Circulation 2005;112:3577–83.Google Scholar
4.Quinn, B. Doyle, McInerney, J. Postnatal precordial pain. Pulmonary embolism or peripartum cardiomyopathy. Emerg Med J 2004;21:746–7.Google Scholar
5.Lampert, MB, Lang, RM. Peripartum cardiomyopath. Am Heart J 1995;130:860–70.CrossRefGoogle Scholar
6.Sliwa, K, Forster, O, Fitzgerald, Z, et al. Outcome of subsequent pregnancy in patients with documented peripartum cardiomyopathy. Am J Cardiol 2004;93:1441–3.CrossRefGoogle ScholarPubMed
7.Sibai, BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol 2003;102:181–92.Google Scholar
8.Benedetti, TJ, Kates, R, Williams, V. Hemodynamic observations in severe preeclampsia complicated by pulmonary edema. Am J Obstet Gynecol 1985;152:330–4.Google Scholar
9.Sibai, BM, Mabie, BC, Harvey, CJ, et al. Pulmonary edema in severe preeclampsia-eclampsia: analysis of thirty-seven consecutive cases. Am J Obstet Gynecol 1987;156:1174–9.Google Scholar
10.Clark, SL, Hankins, GD, Dudley, DA, et al. Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol 1995;172:1158–67.Google Scholar
11.Huybrechts, W, Jorens, PG, Jacquemyn, Y, et al. Amniotic fluid embolsim: a rare cause of acute left-sided heart failure. Acta Cardiol 2006;61:643–9.CrossRefGoogle Scholar
12.Clark, SL, Pavlova, Z, Greenspoon, J, et al. Squamous cells in the maternal pulmonary circulation. Am J Obstet Gynecol 1986;154:104–6.Google Scholar
13.Vanmaele, L, Noppen, M, Vincken, W, et al. Transient left heart failure in amniotic fluid embolism. Intensive Care Med 1990;16:269–71.CrossRefGoogle ScholarPubMed
14.Sciscione, AC, Ivester, T, Largoza, M, et al. Acute pulmonary edema in pregnancy. Obstet Gynecol 2003;101:511–5.Google Scholar