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- W4293096721 abstract "Introduction and aims of the study: Acute pulmonary edema is a rare complication in pregnancy and postpartum, with an estimated incidence between 0.08 and 0.5%. Acute pulmonary edema is the main cardiovascular complication of preeclampsia and one of the criteria of severe preeclampsia; occurs in 3% of preeclampsia cases, 70% of which take place during postpartum. The main risk factors for acute pulmonary edema in preeclampsia are advanced maternal age, multiparity and chronic hypertension. On the other side, preeclamspia and multiparity are risk factors for peripartum cardiomyopathy, which can also present itself with acute pulmonary edema; a common pathophysiological basis between preeclampsia and peripartum cardiomyopathy is under study. Methods: Case report. Results: 39 years-old pregnant women, melanodermic, with known history of unmedicated chronic hypertension (normotensive during pregnancy), two previous caesareans and gestational diabetes in present pregnancy. About 12h after elective caesarean delivery, at 39 weeks and 4 days, diagnosis of hypertensive acute pulmonary edema (blood pressure 172/128 mmHg) in context of postpartum preeclampsia, with clinical improvement after diuretic and vasodilatador therapy. Echocardiogram in intensive care unit revealed peripartum dilated cardiomyopathy with left cavities dilatation and systolic disfunction (ejection fraction of 25%). Treatment included congestive heart failure classic therapy associated to bromocriptine and anticoagulation, with symptomatic resolution and discharge at day 7 of hospital stay and contraindication to future pregnancies. Conclusions: Preeclampsia is one of the major causes of postpartum acute pulmonary edema; this case report illustrates its main risk factors. Otherwise, preeclampsia and peripartum cardiomyopathy can coexist; in these cases, echocardiogram is crucial in differential diagnosis, allowing to exclude other causes of acute pulmonary edema and evaluating cardiac function (systolic disfunction and reduced ejection fraction in peripartum cardiomyopathy versus diastolic disfunction and preserved ejection fraction in preeclampsia)." @default.
- W4293096721 created "2022-08-26" @default.
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- W4293096721 date "2022-03-01" @default.
- W4293096721 modified "2023-09-27" @default.
- W4293096721 title "202 Acute postpartum pulmonary edema – A case report" @default.
- W4293096721 doi "https://doi.org/10.1016/j.ejogrb.2021.11.064" @default.
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