[Non-invasive ventilation for pulmonary edema associated with tocolytic agents during labour for a twin pregnancy].

Abstract

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: Sébastien Perbet, Jean-Michel Constantin, Franck Bolandard, Marie Vignaud, Denis Gallot, Sylvain Chanséaume, Marie Zénut, Jean-Etienne Bazin
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 55 Issue 11 Pg. 769-73 (Nov 2008) ISSN: 0832-610X [Print] United States
• Vernacular Title: Ventilation non-invasive pour oedème pulmonaire attribué aux tocolytiques lors du travail d'une grossesse gémellaire.
• PMID: 19138917 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Tocolytic Agents
• atosiban
• Nicardipine
• Nifedipine
• Vasotocin

Topics

• Adult
• Apgar Score
• Delivery, Obstetric
• Female
• Humans
• Infant, Newborn
• Nicardipine (adverse effects)
• Nifedipine (adverse effects)
• Pleural Effusion (drug therapy)
• Pregnancy
• Pulmonary Edema (chemically induced, therapy)
• Respiration, Artificial
• Tocolytic Agents (adverse effects)
• Tomography, X-Ray Computed
• Twins
• Vasotocin (adverse effects, analogs & derivatives)