Korean J Anesthesiol.  1997 Feb;32(2):311-315. 10.4097/kjae.1997.32.2.311.

Exacerbated Pulmonary Edema in a Toxemia Patient with Mitral Regurgitation during Emergency Cesarean Section: A case report

• Song KJ
• Lim KJ
• Chung CD
• So KY
• Kim YI

• KMID: 2240320
• DOI: http://doi.org/10.4097/kjae.1997.32.2.311

Abstract

Pregnancy-induced hypertension(PIH) is a syndrome of hypertension, proteinuria, generalized edema and occasionally superimposed convulsions after the 20th weeks of gestation. It is a cause of maternal morbidity and mortality. Causes of marternal mortality from PIH include intracranial hemorrage, cerebral edema and pulmonary edema. Mitral regurgitation(MR) is the second most common valvular defect in pregancy, but well tolerated by pregnant women. The reduced systemic vascular resistance characteristic of pregnancy may even reduce the intensity of the murmur of MR becauce of increased forward flow and less backward flow. Acute MR result in a sudden and dramatic increase in left atrial pressure that can lead to pulmonary congestion, pulmonary hypertension and right heart failure. This is a case report of patient with toxemia and MR who underwent emergency cesarean section. She was treated with oxygen, diuretics, steroids, bronchodilators, digitalis, semisitting position, suction and positive end-expiratory pressure(PEEP). She recovered completely.

Keyword

Pregnancy preeclampsia; cesarean section; Heart mitral regurgitation; Complications pulmonary edema

MeSH Terms

Atrial Pressure
Brain Edema
Bronchodilator Agents
Cesarean Section*
Digitalis
Diuretics
Edema
Emergencies*
Estrogens, Conjugated (USP)
Female
Heart Failure
Humans
Hypertension
Hypertension, Pulmonary
Mitral Valve Insufficiency*
Mortality
Oxygen
Pregnancy
Pregnant Women
Proteinuria
Pulmonary Edema*
Seizures
Steroids
Suction
Toxemia*
Vascular Resistance
Bronchodilator Agents
Diuretics
Estrogens, Conjugated (USP)
Oxygen
Steroids