A case of severe preeclampsia presenting as acute pulmonary oedema

Devi, Duvaraha; Kumar, Bindu Vijay

doi:10.18203/2320-1770.ijrcog20160608

Cited by 4 publications

(6 citation statements)

References 11 publications

(13 reference statements)

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“…In preeclampsia the incidence of pulmonary edema is increased due to increased leakage in capillaries and extravasation of fluid from capillaries caused by lung endothelial damage. 16 L-Arginine acts as a NO precursor and is converted to NO and L-citrulline by NOS, which can prevent the occurrence of preeclampsia. This has been the focus of research aimed at investigating the role of prevention in women at high risk for preeclampsia.…”

Section: Resultsmentioning

confidence: 99%

Effect of L-arginine on improvement of alveoli capillary wall thickness

Sulistyowati

Avisena

2018

MOG

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Objectives: This study aims to demonstrate the effect of L-Arginine on pulmonary edema on mice preeclampsia model.Materials and Methods: This experimental analytic study was conducted on 30 pregnant mice divided into 3 groups, namely 10 normal pregnant mice (K1), 10 pregnant mice preeclampsia model (K2), and 10 pregnant mice pre-eclampsia model who received L-Arginine (K3) therapy. All subjects examined the thickness of the alveoli capillary wall in their pulmo using the Immunohisto-chemical method. The results were analyzed using Kruskal Wallis and Mann Whiteney tests.Results: Average alveoli capillary wall thickness (K1) 5.01±1.76/µm, (K2) 11.57±7.11/µm, with p value=0.00. Average alveoli capillary wall thickness (K3) 7.90±4.10/µm with p value=0.01.Conclusion: L-arginine affects to improve pulmonary edema in preeclampsia by reducing alveoli capillary wall thickness of the pulmonary in mice model.

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Section: Resultsmentioning

confidence: 99%

Effect of L-arginine on improvement of alveoli capillary wall thickness

Sulistyowati

Avisena

2018

MOG

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“…Adherence to guidelines was audited. Management of pulmonary oedema in local, regional and international guidelines includes stabilising acute hypertension if present with appropriate medication, increase diuresis with furosemide, give morphine and/or oxygen to relieve symptoms and consider continuous positive airway pressure (CPAP) or mechanical ventilation in case of poor response [18][19][20][21].…”

Section: Methodsmentioning

confidence: 99%

Pulmonary oedema in the course of severe maternal outcome in South Africa: A cohort study combined with clinical audit

Heitkamp

Sandberg

Moodley

et al. 2023

Tropical Med Int Health

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Objectives: To describe the incidence and outcomes of pulmonary oedema in women with severe maternal outcome during childbirth and identify possible modifiable factors through audit. Methods: All women with severe maternal outcome (maternal deaths or near misses) who were referred to Tygerberg referral hospital from health facilities in Metro East district, South Africa, during 2014-2015 were included. Women with severe maternal outcome and pulmonary oedema during pregnancy or childbirth were evaluated using three types of critical incident audit: criterion-based case review by one consultant gynaecologist, monodisciplinary critical incident audit by a team of gynaecologists, multidisciplinary audit with expert review from anaesthesiologists and cardiologists. Results: Of 32,161 pregnant women who gave birth in the study period, 399 (1.2%) women had severe maternal outcome and 72/399 (18.1%) had pulmonary oedema with a case fatality rate of 5.6% (4/72). Critical incident audit demonstrated that pre-eclampsia/ HELLP-syndrome and chronic hypertension were the main conditions underlying pulmonary oedema (44/72, 61.1%). Administration of volumes of intravenous fluids in already sick women, undiagnosed underlying cardiac illness, administration of magnesium sulphate as part of pre-eclampsia management and oxytocin for augmentation of labour were identified as possible contributors to the pathophysiology of pulmonary oedema. Womenrelated factors (improved antenatal care attendance) and health care-related factors (earlier diagnosis and management) would potentially have improved maternal outcome. Conclusions: Although pulmonary oedema in pregnancy is rare, among women with severe maternal outcome a considerable proportion had pulmonary oedema (18.1%). Audit identified options for prevention of pulmonary oedema and improved outcome. These included early detection and management of preeclampsia with close monitoring of fluid intake and cardiac evaluation in case of suspected pulmonary oedema. Therefore, a multidisciplinary clinical approach is recommended.

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“…1,3,6 Pasien preeklamsia dengan komplikasi edema paru, sebaiknya diberikan furosemid intravena 80 mg. 9,10 Pada penelitian lain, furosemide intravena 20-40 mg selama 2 menit dan diulang 40-60 mg setelah 30 menit (maksimum 120 mg/jam). 12 vii. Magnesium sulfat Magnesium tidak direkomendasikan untuk pencegahan preeklamsia.…”

Section: Penegakan Diagnosisunclassified

“…Nitrogliserin Pada hipertensi berat dengan komplikasi edema paru, nitrat seperti nitrogliserin (gliseril tinitrat) merupakan terapi pilihan. 9,10,12,13 Hal ini juga serupa dipaparkan oleh American Heart Association dan European Society of Cardiology. 11 xiv.…”

Section: >25 >30unclassified

Update Manajemen Preeklamsia dengan Komplikasi Berat (Eklamsia, Edema Paru, Sindrom HELLP)

Kesty

Pangemanan²,

Syamsuri³

et al. 2023

Obgynia

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Tujuan: Seiring dengan bertambahnya insidensi preeklamsia dengan komplikasi berat, manajemen yang adekuat diperlukan. Penulisan artikel ini bertujuan untuk memaparkan update manajemen preeklamsia dengan komplikasi berat (eklamsia, edema paru, dan sindrom HELLP). Metode: Tinjauan pustaka (literature review) dengan menggunakan 15 referensi antara tahun 2011–2020. Hasil: Manajemen preeklamsia dengan komplikasi berat membutuhkan pendekatan multidisiplin, medikamentosa (kalsium 1,5–2 gram/hari; aspirin dosis rendah 75–150 mg/hari; MgSO4 dengan dosis awal 4–6 gram IV dan pemeliharaan 1-2 gram/jam hingga 24 jam pascasalin; kortikosteroid; antihipertensi seperti labetalol, hidralazin, nifedipin, natrium nitroprusside, nitrogliserin), dan non-medikamentosa (olahraga, pembatasan cairan). Sementara itu, prinsip penanganan awal eklamsia, yaitu D (Dangers) – R (Response) – S (Send for Help) – A (Airway) – B (Breathing) – C (Compressions) – D (Defibrillation). Adapun manajemen obstetri pada kasus preeklamsia dengan gejala berat, yaitu manajemen ekspektatif dan persalinan (spontan ataupun seksio sesaria). Kesimpulan: Tatalaksana yang cepat dan tepat pada kasus preeklamsia dengan komplikasi berat sangat diperlukan untuk mengurangi morbiditas pada ibu dan janin. Manajemen kasus preeklamsia dengan gejala berat berupa manajemen ekspektatif dan persalinan (spontan ataupun seksio sesaria). Update on Management of Preeclampsia with Severe Features (Eclampsia, Pulmonary Edema, HELLP Syndrome) Abstract Objective: As the incidence of preeclampsia with severe features increases, adequate management is required. The purpose of this review is to present an update on the management of preeclampsia with severe features (eclampsia, pulmonary edema, and HELLP syndrome). Method: Literature review using 15 references between 2011–2020. Results: Management of preeclampsia with severe features requires a multidisciplinary, medical approach (calcium 1.5–2 g/day; low-dose aspirin 75–150 mg/day; magnesium sulfate at an initial dose of 4–6 g IV and maintenance 1-2 g/hour to 24 hours postpartum; corticosteroids; antihypertensives such as labetalol, hydralazine, nifedipine, sodium nitroprusside, nitroglycerin) and non-medical (exercise, fluid restriction). Meanwhile, the principles of early management of eclampsia, namely D (Dangers) – R (Response) – S (Send for Help) – A (Airway) – B (Breathing) – C (Compressions) – D (Defibrillation). The obstetric management in cases of preeclampsia with severe features is expectant management and delivery (spontaneous or cesarean section). Conclusion: Prompt and appropriate management of cases of preeclampsia with severe features is needed to reduce maternal and fetal morbidity. Management of preeclampsia cases with severe features is expectant management and delivery (spontaneous or cesarean section). Key words: preeclampsia, eclampsia, HELLP syndrome, severe.

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A case of severe preeclampsia presenting as acute pulmonary oedema

Cited by 4 publications

References 11 publications

Effect of L-arginine on improvement of alveoli capillary wall thickness

Effect of L-arginine on improvement of alveoli capillary wall thickness

Pulmonary oedema in the course of severe maternal outcome in South Africa: A cohort study combined with clinical audit

Update Manajemen Preeklamsia dengan Komplikasi Berat (Eklamsia, Edema Paru, Sindrom HELLP)

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