Late postpartum preeclampsia induced acute pulmonary edema, a rare presentation of a common disease: A case report

  • João Rua | Joaomfrua@gmail.com Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.
  • Joana Costa Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.
  • José Leite Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.
  • Ricardo Marques Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.
  • Joana Queiró Medical Emergency Unit, S. José Hospital, Central Lisboa Hospital Centre, Lisboa, Portugal.
  • Jorge Fortuna Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.
  • Adriano Rodrigues Internal Medicine Department B, General Hospital, University of Coimbra, Coimbra, Portugal.

Abstract

Preeclampsia is a disorder of widespread vascular endothelial dysfunction and vasospasm associated with pregnancy. It can occur from the 20th week to 4-6 weeks postpartum, resulting in hypertension, proteinuria and, in severe cases, end-organ damage and death. A 31-year-old puerpera enters the emergency room with complaints of dyspnea and leg edema, two weeks after the delivery. She was polipneic and hypertensive, had vascular congestion on thorax x-ray, elevated d-dimers and NT-proBNP. Meanwhile pulmonary embolism was suspected, she developed an acute pulmonary edema. Exams excluded embolism and cardiac abnormalities. New onset proteinuria allowed to diagnose a severe postpartum preeclampsia. About 5.7% of preeclampsia occurs in the postpartum but this is sometimes neglected. As progression to eclampsia isn’t influenced by control of hypertension or severe symptoms and seizure complications are a major cause of morbimortality, its recognition and institution of prophylaxis with magnesium sulphate is crucial.

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Published
2018-05-28
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Section
Case Reports
Keywords:
Postpartum preeclampsia, Severe preeclampsia, Pulmonary edema.
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How to Cite
Rua, J., Costa, J., Leite, J., Marques, R., Queiró, J., Fortuna, J., & Rodrigues, A. (2018). Late postpartum preeclampsia induced acute pulmonary edema, a rare presentation of a common disease: A case report. Emergency Care Journal, 14(1). https://doi.org/10.4081/ecj.2018.7240