Initial Management of Acute Pulmonary Edema in Pre-Eclampsia: A Case Report

Abstract

Objective: Describe the initial management for acute pulmonary edema in pre-eclampsia. Methods: A case report. Case: 41-year-old woman, G5P4A0, unknown gestational age, admitted with headache, dyspnea, and unconsciousness. The patient denied a history of past illness. Crisis hypertension, tachypnea, tachycardia, low oxygen saturation, audible lung crackles, pretibial edema, and 3+ proteinuria were found on examination, consistent with the diagnosis of pre-eclampsia with severe features. For initial management of acute pulmonary edema, the patient was given oxygen with Jackson-Rees bagging and furosemide injection, while nicardipine drip and MgSO4 injection were also given to treat pre-eclampsia. After the right initial management, patient was fully conscious, stable, then treated in the intensive care unit using non-invasive positive pressure ventilation. The patient underwent vaginal delivery and gave birth to male, BW 2900gram, BL 47cm, APGAR 3/8. Discussion: Initial emergency management focuses on providing adequate oxygen is the main management of pulmonary edema in preeclampsia. A non-invasive positive pressure ventilation is required as the main flow of oxygen delivery because it’s not invasive and is more convenient. Additional therapy such as diuretics, antihypertensive, and anticonvulsant are also needed. Close monitoring in the intensive care unit was also required for best results. Conclusion: Initial management of acute pulmonary edema in pre-eclampsia patients should be done correctly, consequently decreasing maternal and perinatal morbidity and mortality.