Acute Pulmonary Edema in the Parturient Pretreated with Ritodrine during Cesarean Section under Epidural Anesthesia: A case report / 대한마취과학회지

Ritodrine hydrochloride (Yutopar (R)) is widely used for the treatment of premature uterine contraction with betasympathomimetic effect on the uterus but adverse effects associated with cardiopulmonary system are frequently reported. We experienced a case of pulmonary edema that occurred suddenly during cesarean section under epidural anesthesia. She had been treated with ritodrine for 3 days to arrest preterm labor of twin pregnancy. Intensive care including mechanical ventilation with PEEP via endotracheal intubation and diuretic therapy was attempted. At the 3rd day after operation patient was transferred to general ward without any sequale.

Pulmonary Edema Caused by Intrauterine Dextran during Hysteroscopy: A case report / 대한마취과학회지

Dextran is a highly viscous polysaccharide liquid used for uterine distention during hysteroscopic surgery. Although generally safe, this agent has been recognized to cause non-cardiogenic pulmonary edema, intravascular coagulopathy, renal insufficiency, and anaphylactic reaction. We report the case of pulmonary edema following hysteroscopic surgery with dextran 40 and discuss the major side effects and the possible etiologies of the reported complication.

Acute Pulmonary Edema Occurred During the Cesarean Section in a Patient with Ritodrine Pretreatment: A case report / 대한마취과학회지

The mechanism of development of pulmonary edema associated with -sympathomimetic agent is still not fully understood. 2-sympathomimetic drugs such as ritodrine, terbutaline, and fenoterol are widely used for the treatment of premature uterine contraction. We describe a case of pulmonary edema that occurred suddenly during Cesarean section in a previously healthy parturient, associated with ritodrine pretreatment for 5 days in an attempt to arrest preterm labor. Pulmonary edema was completely treated with mechanical ventilation and diuretic therapy.

Exacerbated Pulmonary Edema in a Toxemia Patient with Mitral Regurgitation during Emergency Cesarean Section: A case report / 대한마취과학회지

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.