Pulmonary edema during pregnancy: unilateral presentation is not rare

Information regarding pulmonary edema in obstetric patients is limited, especially its natural history as most cases are from tertiary care centers. The incidence, etiology, and course of pulmonary edema in all obstetric patients at a primary-secondary care center was studied prospectively among 29,621 obstetric cases in the past 3.5 years. Pulmonary edema developed in 18 cases (0.06%) of all obstetric patients that were associated with pre-eclampsia-eclampsia and tocolysis with beta-mimetics. The onset of pulmonary edema was 1-8 days postpartum in 12 patients, 1 day antepartum in 3 patients, and 26-32 gestational weeks in 3 patients. The cause was mainly cardiogenic, and the mean time taken for resolution was 2.2 days. Unilateral pulmonary edema occurred in 4 patients and there was delayed resolution compared with bilateral pulmonary edema because of delayed treatment. Pulmonary edema associated with pregnancy developed in 0.06% of cases, mainly during the peripartum, and resolved rapidly. Unilateral pulmonary edema was not uncommon.