| Exacerbated Pulmonary Edema in a Toxemia Patient with Mitral Regurgitation during Emergency Cesarean Section: A case report. |
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Kyoung Joon Song, Kyung Joon Lim, Chong Dal Chung, Keum Young So, Yong Il Kim |
1Department of Anesthesiology, College of Medicine, Chosun University, Kwangju, Korea.
2Department of Anesthesiology, Kyungpook National University College of Medicine, Taegu, Korea. |
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| Abstract |
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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. |
| Key Words:
Pregnancy preeclampsia; cesarean section; Heart mitral regurgitation; Complications pulmonary edema |
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