Peri-operative Pulmonary Edema a manifestation of Peripartum Cardiomyopathy

ABSTRACT

A 20 years primigravida presented in emergency with history of pulmonary edema after caesarean hysterectomy under spinal anesthesia, complicated by cardiac arrest. On examination, the patient was conscious, anxious and restless, pale, cyanosed, had edema face and feet, distended neck veins and was orthopnoeic. X-ray chest showed diffuse homogenous opacities in both lung fields. A provisional diagnosis of over transfusion pulmonary edema was made. She was placed on ventilatory support on synchronized intermittent mandatory ventilation [SIMV] along with positive end expiratory pressure [PEEP]. Her endotracheal suction had to be performed quite frequently due to exuberant amount of edema fluid. She was given diuretics, antibiotics and analgesics