Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pregnancy Hypertens. 2021 Aug;25:150-155. doi: 10.1016/j.preghy.2021.05.019. Epub 2021 Jun 2.
Acute pulmonary edema is a rare complication in women with preeclampsia especially at advanced maternal age. We aimed to determine the cardiovascular hemodynamics in advanced maternal age women who developed acute pulmonary edema and preeclampsia.
Retrospective cohort study of women aged over 45 years giving birth at single university affiliated tertiary medical center which developed acute pulmonary edema due to severe preeclampsia. Clinical features were identified in order to predict and potentially prevent this severe complication of pregnancy.
Advanced maternal age women who developed acute pulmonary edema due to preeclampsia.
Overall, during the study period 90,540 women delivered in our hospital, of them, 540 women (0.6%) above the age of 45 years gave birth. Of those, 67 women (12.4%) had preeclampsia in which 4 women (6%) were complicated with acute pulmonary edema. The common clinical relevant characteristics for all four women were: preterm delivery by cesarean section for preeclampsia with severe features, non-restrictive fluid management around the time of delivery, post-partum pain control medication with non-steroidal anti-inflammatory drug, blood pressure stabilization with oral labetalol and a sudden hemodynamic deterioration to hypertensive crisis and pulmonary edema between post-operative days 4-9.
Although the precise trigger for the sudden presentation of acute pulmonary edema remains unknown, we suggest that there is a multi-factorial combination of etiologies that are common to women of advanced maternal age and women with preeclampsia that could have contributed to the development of pulmonary edema.
子痫前期患者并发急性肺水肿较为罕见，尤其是在高龄产妇中。本研究旨在探讨高龄产妇并发子痫前期导致急性肺水肿的心血管血流动力学变化。
回顾性队列研究，研究对象为在单所大学附属三级医疗中心分娩的年龄超过 45 岁的子痫前期并发急性肺水肿的女性。确定了相关临床特征，以预测和潜在预防妊娠的这一严重并发症。
子痫前期导致急性肺水肿的高龄产妇。
研究期间，我院共有 90540 名妇女分娩，其中 540 名（0.6%）年龄超过 45 岁。其中，67 名（12.4%）患有子痫前期，其中 4 名（6%）并发急性肺水肿。所有 4 名女性共同的临床相关特征为：严重特征的子痫前期行剖宫产术早产，分娩前后非限制性液体管理，产后使用非甾体抗炎药止痛，口服拉贝洛尔稳定血压，术后第 4-9 天血压突然升高至高血压危象和肺水肿。
尽管急性肺水肿突然发作的确切诱因尚不清楚，但我们认为，高龄产妇和子痫前期患者可能存在多种共同的病因，导致肺水肿的发生。
