OBJECTIVE: To describe the efficacy and patient acceptance of non-invasive ventilation for pulmonary edema associated with administration of tocolytic drugs during labour of a twin pregnancy. CLINICAL FEATURES: We report the case of a 31-yr-old parturient at 34 weeks gestation of a twin pregnancy, who experienced acute pulmonary edema after tocolytic treatment with nifedipine, nicardipine and atosiban of > 48 hr in duration. This patient presented with hypoxia during labour and non-invasive ventilation was successfully used allowing delivery by vaginal approach, with patient-controlled epidural analgesia, of two twins with a five minute Apgar score of 8. Investigations showed acute pulmonary edema and important transudate pleural effusions with left ventricular systolic dysfunction induced by calcium-antagonist, with favourable outcome after symptomatic treatment. CONCLUSION: When pulmonary edema occurs during pregnancy, non-invasive ventilation could be an efficacious treatment, this avoiding tracheal intubation and its complications.
OBJECTIVE: To describe the efficacy and patient acceptance of non-invasive ventilation for pulmonary edema associated with administration of tocolytic drugs during labour of a twin pregnancy. CLINICAL FEATURES: We report the case of a 31-yr-old parturient at 34 weeks gestation of a twin pregnancy, who experienced acute pulmonary edema after tocolytic treatment with nifedipine, nicardipine and atosiban of > 48 hr in duration. This patient presented with hypoxia during labour and non-invasive ventilation was successfully used allowing delivery by vaginal approach, with patient-controlled epidural analgesia, of two twins with a five minute Apgar score of 8. Investigations showed acute pulmonary edema and important transudate pleural effusions with left ventricular systolic dysfunction induced by calcium-antagonist, with favourable outcome after symptomatic treatment. CONCLUSION: When pulmonary edema occurs during pregnancy, non-invasive ventilation could be an efficacious treatment, this avoiding tracheal intubation and its complications.
Authors: Vicki Flenady; Aleena M Wojcieszek; Dimitri N M Papatsonis; Owen M Stock; Linda Murray; Luke A Jardine; Bruno Carbonne Journal: Cochrane Database Syst Rev Date: 2014-06-05
Authors: Claire Serena; Emmanuelle Begot; Jérôme Cros; Charles Hodler; Anne Laure Fedou; Nathalie Nathan-Denizot; Marc Clavel Journal: Case Rep Crit Care Date: 2014-08-19