Acute pulmonary edema in labor can be fatal

The article was consulted professionally by Specialist Doctor II Bui Thi Thu – Obstetrician and Gynecologist – Obstetrics and Gynecology Department – Share99 Hai Phong International Health Hub.

Pregnant women with a number of cardiovascular diseases, gestational hypertension, pre-production or seizure manifestations, or infections during pregnancy are at acute risk of pulmonary edema during labor.

During pregnancy due to changes related to the fetus, many women may experience problems related to cardiovascular disease, gestational hypertension, pre-obstetricmanifestations, obstetrics or gynecology with infections during pregnancy, it is very susceptible to acute pulmonary edema in obstetrics. Acute pulmonary edema is also caused by excessive infusion and at a rapid rate. Acute pulmonary edema may appear during pregnancy, during labor or even after childbirth.

Acute pulmonary edema in obstetrics is prone to death for both mother and child if not detected early, diagnosed and handled in a timely manner. In fact, in some localities, especially on the frontline, there are cases of acute lung edema that occurs for women during labor but late detection and not active handling, leading to unfortunate consequences.

• Heart disease: Depending on the degree of severe or mild acute pulmonary edema of heart disease the most typical of which is mitral valve stenosis with its main complications being pulmonary edema (70-90%). The tighter the disease, the more likely it is to have complications. In case of damage to multiple heart valves, the more severe the acute pulmonary edema in obstetrics and gynecology.
• Number of calving: Those who give birth compared to the risk of the appearance of heart disease and acute pulmonary edema in labor are lower than for many calving people.
• Gestational age: The larger the fetus, the more acute pulmonary edema events in obstetrics occur.
• Pregnancy hypertension, especially severe pre-embolism, is a favorable condition for the appearance of acute pulmonary edema that occurs in the case of a vascular filling procedure when anesthesia of the stenosis or spinal cord in vain for hypertension.
• Acute pulmonary edema in obstetrics can also occur in the post-obstetric stage, which is the peak period, which can be more severe than during pregnancy, usually blood pressure rises back to a high 12th hour after calving. This is a period of prone to the appearance of acute heart failure and pulmonary edema, the risk of which will increase if there is a lot of edema, a lot of infusions during calving.
• Medical conditions such as anemia, malnutrition, bacterialinfections, malaria and kidney disease, drug poisoning and other toxins … is the risk that can lead to acute pulmonary edema during labor.

Acute pulmonary edema in obstetrics may appear during pregnancy, during labor or after childbirth

• Sudden shortness of breath, rapid breathing, coughing, purple lips and head, mental panic, chest pain, cold limbs, cold sweating.
• Hearing the lungs detect a small damp ranm at the base of the lungs rises rapidly, knocking on the chisel at the base of the lungs.
• From dry cough to pink foam phlegm more and more.
• Heart listening: tachycardia > 100 times per minute, accompanied by sick heart sounds. Sometimes you hear the sound of horses.
• Blood pressure measurement: high blood pressure or jam.
• High central vein pressure (CVP) measurement, signs of floating cervical vein.
• Cardicardimonary X-rays show signs of blurred lungs.

Note that it is necessary to diagnose the difference between asthma attacks and manifestations when hearing lungs with a lot of squeaking and snoring, echo knocking, chest tightness and asthma attacks with the understanding that there is difficulty breathing in exhalation, squeaking.

• In the face of an acute case of pulmonaryedema in obstetrics , active treatment initially plays an important role for obstetrics and gynecology through critical illness.
• Check and monitor for signs of survival: Pulse, blood pressure, breathing rate, temperature, cardiocular listening.
• Ensure respiratory ventilation for the maternity by lying on the head high.
• Suction of sputum clears the respiratory tract, gives the maternity oxygen.
• Repeat intravenous transmission.
• Advise the family on the serious condition of acute pulmonary edema in obstetrics, the risk that can be encountered for the mother and for the child.
• The commune must be injected under the skin of 10mg of morphine and transferred to the district line immediately, accompanied by medical staff, for women to breathe oxygen (if any), high head position when transferring.

For baseline

• Inform the upline for help, mobilize all available staff to focus on maternity emergency.
• Perform initial handling.
• Advising the family and moving up, accompanied by medical staff.

District or higher routes

• Let the pregnant woman sit upright, legs.
• Garo three alternates.
• In the insymed administration sucks sputum, breathes 60% oxygen with a capacity of 8-12 liters / min.
• Intravenously: 128 Weeds (the selected drug is usually lasix 20mg x 4 ampers). When necessary it is possible to increase the dose, depending on the amount of urine and the shortness of breath of the person. Cardiac support: Small cedilanit 0.4mg x 1-2 amp tubes. Subcutaneous injection of 10mg of morphine. In many cases it is necessary to extract intravenous blood. It is recommended to extract 300ml of blood.
• Obstetrics and Gynecology: Cesarean section surgery when the condition of the pregnant woman allows or forceps if eligible

In case of acute pulmonary edema in obstetrics due to injury, it is necessary to:

• Insymed administration ventilator, respiratory support, oxygen breathing.
• Intravenous dopamine is used.
• Plasma infusion.
• Use high-dose antibiotics.
• Methyl prednisolon: 30mg intravenously, every 4 hours.
• Cesarean section surgery when maternity status allows or perform forceps if eligible.

At Share99 International Health Hub, there is a full maternity service as a solution to help pregnant mothers feel secure because there is a team of doctors throughout the pregnancy. When choosing a full-service maternity, a pregnant woman can:

• The process of pregnancy is monitored by a team of specialists
• Regular examination, early detection of abnormalities
• Package maternity for the convenience of childbirth
• Infants receive comprehensive care